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General NPI Number Information
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NPI Number | 1023759024
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Entity Type | Organization
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Legal Business Name | CANYON CONSULTING GROUP
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 31630 RAILROAD CANYON RD STE 2A
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City | CANYON LAKE
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State | CA
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Zip | 92587-9478
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Country | US
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Telephone | 951-485-3357
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Fax |
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Provider Business Mailing Address
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Address Line | 22663 BUTTERCUP PL
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City | CANYON LAKE
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State | CA
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Zip | 92587-7818
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Country | US
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Telephone | 951-488-8400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANELA G RICHIE
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Credential | LMFT
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Telephone | 951-488-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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