Provider Demographics
NPI:1316401607
Name:VAPHIDES, RACHAEL (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:VAPHIDES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 PEMBER AVE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-4320
Mailing Address - Country:US
Mailing Address - Phone:808-375-9882
Mailing Address - Fax:
Practice Address - Street 1:1750 PEMBER AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-4320
Practice Address - Country:US
Practice Address - Phone:808-375-9882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW817231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical