Provider Demographics
NPI:1609307461
Name:PHILIP RAHM, PH.D LMFT MARRIAGE AND FAMILY THERAPY
Entity Type:Organization
Organization Name:PHILIP RAHM, PH.D LMFT MARRIAGE AND FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:650-329-9660
Mailing Address - Street 1:1225 CRANE ST
Mailing Address - Street 2:108
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4257
Mailing Address - Country:US
Mailing Address - Phone:650-329-9660
Mailing Address - Fax:650-329-1918
Practice Address - Street 1:1225 CRANE ST
Practice Address - Street 2:SUITE 108
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4257
Practice Address - Country:US
Practice Address - Phone:650-329-9660
Practice Address - Fax:650-329-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21773261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)