Provider Demographics
NPI:1003984949
Name:RICHARDS, ANNELI KIM (MS)
Entity Type:Individual
Prefix:MS
First Name:ANNELI
Middle Name:KIM
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 SANTA BARBARA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1628
Mailing Address - Country:US
Mailing Address - Phone:415-272-1302
Mailing Address - Fax:
Practice Address - Street 1:171 CARLOS DR
Practice Address - Street 2:BAY AREA COMMUNITY RESOURCES
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2005
Practice Address - Country:US
Practice Address - Phone:415-444-5580
Practice Address - Fax:415-444-5598
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTI42350101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health