Provider Demographics
NPI:1386360550
Name:RICHARDS, ANGELA ALICIA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:ALICIA
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BIG TREES RD STE D
Mailing Address - Street 2:
Mailing Address - City:MURPHYS
Mailing Address - State:CA
Mailing Address - Zip Code:95247-9101
Mailing Address - Country:US
Mailing Address - Phone:209-890-7124
Mailing Address - Fax:
Practice Address - Street 1:150 BIG TREES RD STE D
Practice Address - Street 2:
Practice Address - City:MURPHYS
Practice Address - State:CA
Practice Address - Zip Code:95247-9101
Practice Address - Country:US
Practice Address - Phone:209-890-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health