Provider Demographics
NPI:1508048679
Name:MAND, RACHELLE RUBENI (PHD)
Entity Type:Individual
Prefix:DR
First Name:RACHELLE
Middle Name:RUBENI
Last Name:MAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24586 HAWTHORNE BLVD
Mailing Address - Street 2:#9
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6857
Mailing Address - Country:US
Mailing Address - Phone:310-375-2100
Mailing Address - Fax:310-375-2100
Practice Address - Street 1:24586 HAWTHORNE BLVD
Practice Address - Street 2:#9
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6857
Practice Address - Country:US
Practice Address - Phone:310-375-2100
Practice Address - Fax:310-375-2100
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT15445106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist