Healthcare Provider Details

I. General information

NPI: 1952106841
Provider Name (Legal Business Name): ANUM RATHOR LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4361 LATHAM ST STE 220
RIVERSIDE CA
92501-1767
US

IV. Provider business mailing address

4361 LATHAM ST STE 220
RIVERSIDE CA
92501-1767
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-1223
  • Fax: 858-467-7161
Mailing address:
  • Phone: 858-279-1223
  • Fax: 858-467-7161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number151118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: