Provider Demographics
NPI:1124217625
Name:TALAMANTEZ, RACHEL JENNIFER (MFT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JENNIFER
Last Name:TALAMANTEZ
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 8011
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95155-8011
Mailing Address - Country:US
Mailing Address - Phone:408-922-9025
Mailing Address - Fax:408-689-1025
Practice Address - Street 1:1588 HOMESTEAD RD
Practice Address - Street 2:SUITE F
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4783
Practice Address - Country:US
Practice Address - Phone:408-922-9025
Practice Address - Fax:408-689-1025
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2011-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42820106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist