Provider Demographics
NPI:1164670428
Name:GOLDBERG, RACHEL (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11239 VENTURA BLVD STE 103-106
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3163
Mailing Address - Country:US
Mailing Address - Phone:424-245-0223
Mailing Address - Fax:
Practice Address - Street 1:11239 VENTURA BLVD STE 103-106
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-3163
Practice Address - Country:US
Practice Address - Phone:424-245-0223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X, 390200000X
CA143189106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program