Provider Demographics
NPI:1013206804
Name:TARFMAN-PEREZ, RACHAEL (MFT)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:TARFMAN-PEREZ
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20398
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92728-0398
Mailing Address - Country:US
Mailing Address - Phone:714-478-2996
Mailing Address - Fax:714-641-0334
Practice Address - Street 1:2900 BRISTOL ST
Practice Address - Street 2:SUITE G201
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5981
Practice Address - Country:US
Practice Address - Phone:714-478-2996
Practice Address - Fax:714-641-0334
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40398106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist