Provider Demographics
NPI:1528576261
Name:KABAH, RHODEL CHRISTINE (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:RHODEL
Middle Name:CHRISTINE
Last Name:KABAH
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:RHODEL
Other - Middle Name:CHRISTINE
Other - Last Name:SWANIKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1968 S COAST HWY # 803
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-3681
Mailing Address - Country:US
Mailing Address - Phone:210-390-6929
Mailing Address - Fax:844-300-5483
Practice Address - Street 1:3600 LIME ST # 216-103A
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-2971
Practice Address - Country:US
Practice Address - Phone:877-712-5220
Practice Address - Fax:844-300-5483
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2023-03-01
Deactivation Date:2020-11-13
Deactivation Code:
Reactivation Date:2023-03-01
Provider Licenses
StateLicense IDTaxonomies
CA19942101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
14178089OtherCAQH PROVIEW