Provider Demographics
NPI:1417473729
Name:PAZOS, RAQUEL (LMFT)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:PAZOS
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 1:2855 TELEGRAPH AVE STE 515
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1151
Mailing Address - Country:US
Mailing Address - Phone:415-873-1493
Mailing Address - Fax:
Practice Address - Street 1:2855 TELEGRAPH AVE STE 515
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1151
Practice Address - Country:US
Practice Address - Phone:415-873-1493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101073106H00000X
CA122575106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist