Provider Demographics
NPI:1053656314
Name:MACDOUGALL, RACHEL DAY (MS BCBA)
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:DAY
Last Name:MACDOUGALL
Suffix:
Gender:F
Credentials:MS BCBA
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Mailing Address - Street 1:520 NEWPORT CENTER DR STE 550
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7020
Mailing Address - Country:US
Mailing Address - Phone:603-770-1089
Mailing Address - Fax:
Practice Address - Street 1:920 HYMETTUS AVE # 2
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2153
Practice Address - Country:US
Practice Address - Phone:603-770-1089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
CA01-12-12587103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist