Provider Demographics
NPI:1346645322
Name:DEHAAN, RACHEL (MSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DEHAAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WEST BROADWAY
Mailing Address - Street 2:SUITE 5005
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804
Mailing Address - Country:US
Mailing Address - Phone:562-285-1330
Mailing Address - Fax:562-285-1336
Practice Address - Street 1:100 WEST BROADWAY
Practice Address - Street 2:SUITE 5005
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804
Practice Address - Country:US
Practice Address - Phone:562-285-1330
Practice Address - Fax:562-285-1336
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW62730101YM0800X
CA853311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health