Provider Demographics
NPI:1609522879
Name:PEARL, RACHEL (LMFT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PEARL
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 1:3371 GLENDALE BLVD # 187
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1846
Mailing Address - Country:US
Mailing Address - Phone:323-505-2154
Mailing Address - Fax:
Practice Address - Street 1:650 S CLOVERDALE AVE APT 4
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4118
Practice Address - Country:US
Practice Address - Phone:213-400-0416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist