Provider Demographics
NPI:1235592767
Name:MATTSON, RACHEL (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MATTSON
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23241 S POINTE DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1413
Mailing Address - Country:US
Mailing Address - Phone:949-457-9203
Mailing Address - Fax:949-457-9213
Practice Address - Street 1:23241 S POINTE DR
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1413
Practice Address - Country:US
Practice Address - Phone:949-457-9203
Practice Address - Fax:949-457-9213
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-16-21747103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst