Provider Demographics
NPI:1215018437
Name:LAUBER, RACHEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:LAUBER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1507 7TH ST # 126
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2605
Mailing Address - Country:US
Mailing Address - Phone:310-531-8929
Mailing Address - Fax:310-531-8929
Practice Address - Street 1:1137 2ND ST STE 120
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5011
Practice Address - Country:US
Practice Address - Phone:310-531-8929
Practice Address - Fax:310-531-8929
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19461103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL194610Medicare ID - Type Unspecified