Provider Demographics
NPI:1366581217
Name:RUNYAN, JAMES D (MS, MFT, LPC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:RUNYAN
Suffix:
Gender:M
Credentials:MS, MFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E REDLANDS BLVD STE U # 272
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6168
Mailing Address - Country:US
Mailing Address - Phone:909-289-9822
Mailing Address - Fax:
Practice Address - Street 1:11913 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2607
Practice Address - Country:US
Practice Address - Phone:909-289-9822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 1737101Y00000X
CAMFC 38932106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist