Individual provider Active NPI

Miranda Alayne Rich, LMFT

  • Marriage & Family Therapist
  • Agoura Hills, CA
National Provider Identifier
1053952622
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
150157 Issued in CA
Practice address
5012 Chesebro Rd Ste 200
Agoura Hills, CA 91301-2287
Phone
(925) 282-1778
NPI assigned
Oct 3, 2019
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 150157 CA Primary

Addresses

Primary practice location

5012 Chesebro Rd Ste 200
Agoura Hills, CA 91301-2287

Mailing address

5012 Chesebro Rd Ste 200
Agoura Hills, CA 91301-2287

Other practice location 1

115 E Hickory Ave Ste C
Lompoc, CA 93436-7274
Phone (805) 448-5733

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Lompoc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120002515 CA Practitioner - Marriage and Family Therapist 8325573801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

5012 Chesebro Rd
Suite 200
Agoura Hills, CA 91301-2287
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150157CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Nov 15, 2024 Accepting new patients

Locations

5012 Chesebro Rd
Ste 200
Agoura Hills, CA 91301
Phone (614) 943-0819

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 434-0011

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1053952622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 CHESEBRO RD STE 200",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913012287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 CHESEBRO RD STE 200",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913012287",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 E Hickory Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Lompoc",
            "state": "CA",
            "postal_code": "934367274",
            "country_code": "US",
            "telephone_number": "805-448-5733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICH",
        "first_name": "MIRANDA",
        "middle_name": "ALAYNE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "150157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Lompoc",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "115 E Hickory Ave Ste C",
            "city": "Lompoc",
            "state": "CA",
            "country_code": "US",
            "postal_code": "934367274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Agoura Hills, CA

Sources for this page

Verify at the official NPI Registry.