Provider Demographics
NPI:1215544788
Name:WHITE, RACHEL (LMFT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WHITE
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 1:5328 NEWCASTLE AVE UNIT 62
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3027
Mailing Address - Country:US
Mailing Address - Phone:747-236-1181
Mailing Address - Fax:
Practice Address - Street 1:21243 VENTURA BLVD STE 118
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2162
Practice Address - Country:US
Practice Address - Phone:818-979-0065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122106106H00000X
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist