| Doctor Name: | DR. RICHARD P CARUSO |
| NPI Number: | 1083777965 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | PSY 4650 |
| Business Practice Address: | 7470 Kennedy Rd Sebastopol, CA - 954725420 |
| Business Phone Number: | 7075441707 |
| Business Fax Number: | |
| Mailing Address: | 7470 Kennedy Rd, SEBASTOPOL |
| State: | CA |
| Postal Code: | 954725420 |
| Phone Number: | 7075441707 |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 08/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY 4650 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |