Richard Ettelson, PHD
NPI 1174569453 · Clinical Psychologist · Rancho Cucamonga, CA
Enrolled with Medicare as Practitioner - Clinical Psychologist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Richard Ettelson, PHD is a Clinical Psychologist provider in Rancho Cucamonga, CA (NPI 1174569453).
Provider details
- NPI number
- 1174569453
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Male
- Sole proprietor
- No
- License
- D5418953 (CA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 10722 Arrow Rte314Rancho Cucamonga, CA 91730-4808Phone: (909) 367-3333
Registry dates
- Enumerated
- 2006-06-22
- Last updated
- 2018-09-18
Frequently asked questions
- What is Richard Ettelson's NPI number?
- Richard Ettelson's National Provider Identifier (NPI) is 1174569453, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Richard Ettelson's specialty?
- Richard Ettelson is listed in the NPPES registry with a primary specialty of Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Richard Ettelson located?
- Richard Ettelson's practice location on file with NPPES is 10630 Town Center Dr Ste 120, Rancho Cucamonga, CA 91730-6889.
- What is Richard Ettelson's phone number?
- The practice phone number listed in the NPPES registry for Richard Ettelson is (909) 989-0901.
- Does Richard Ettelson accept Medicare?
- Richard Ettelson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Richard Ettelson's NPI active?
- Yes — Richard Ettelson's NPI (1174569453) is active in the NPPES registry as of the last update on 2018-09-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.