Provider Demographics
NPI:1174334155
Name:HAGAMAN, RICHARD K II
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:K
Last Name:HAGAMAN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6231 LE SAGE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-1327
Mailing Address - Country:US
Mailing Address - Phone:310-435-2309
Mailing Address - Fax:
Practice Address - Street 1:30125 AGOURA RD STE F
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4337
Practice Address - Country:US
Practice Address - Phone:805-659-8429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health