Provider Demographics
NPI:1518093343
Name:ACOSTA, RACHEL ANN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ANN
Last Name:ACOSTA
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 1:3601 PRESCOTT RD APT 102
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-2717
Mailing Address - Country:US
Mailing Address - Phone:209-404-0700
Mailing Address - Fax:
Practice Address - Street 1:1904 RICHLAND AVE
Practice Address - Street 2:
Practice Address - City:CERES
Practice Address - State:CA
Practice Address - Zip Code:95307-4562
Practice Address - Country:US
Practice Address - Phone:209-558-4600
Practice Address - Fax:209-541-2549
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT44941106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist