MEDICARE: MS. ANELA GAIL RICHIE LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	115341	CA

General Provider Information

NPI Number	:	1417598822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANELA GAIL RICHIE LMFT

Provider Business Mailing Address
First Line	:	22663 BUTTERCUP PL
Second Line	:
City	:	CANYON LAKE
State	:	CA
Zip	:	92587-7818
Country	:	US
Telephone Number	:	951-585-3357
Fax Number	:	855-719-3137

Provider Business Practice Location Address
First Line	:	31526 RAILROAD CANYON RD STE 5
Second Line	:
City	:	CANYON LAKE
State	:	CA
Zip	:	92587-9443
Country	:	US
Telephone Number	:	951-585-3357
Fax Number	:	855-719-3137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2019
Last Update Date	:	05/07/2025

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