Provider Demographics
NPI:1619259082
Name:RAINS, CAROLINE SUZANNE (LMFT #90977, LF61260)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:SUZANNE
Last Name:RAINS
Suffix:
Gender:F
Credentials:LMFT #90977, LF61260
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 BELL RD # 212
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2540
Mailing Address - Country:US
Mailing Address - Phone:408-384-9612
Mailing Address - Fax:
Practice Address - Street 1:4010 MOORPARK AVE STE 118
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-1804
Practice Address - Country:US
Practice Address - Phone:408-384-9612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61260064106H00000X
CA90977106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist