Provider Demographics
NPI:1578733978
Name:MARKS, RACHEL MELISSA (PSYD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MELISSA
Last Name:MARKS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S BEVERLY DR
Mailing Address - Street 2:SUITE # 307
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4312
Mailing Address - Country:US
Mailing Address - Phone:424-284-7899
Mailing Address - Fax:
Practice Address - Street 1:315 S BEVERLY DR
Practice Address - Street 2:SUITE #
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4312
Practice Address - Country:US
Practice Address - Phone:424-284-7899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22101103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist