Provider Demographics
NPI:1629395066
Name:GOLDBERG, RACHEL B (MD, MPH)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:B
Last Name:GOLDBERG
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Gender:F
Credentials:MD, MPH
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3025 HAMAKER CT STE 290
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2237
Mailing Address - Country:US
Mailing Address - Phone:703-448-0252
Mailing Address - Fax:
Practice Address - Street 1:3025 HAMAKER CT STE 290
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2237
Practice Address - Country:US
Practice Address - Phone:703-448-0252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012558862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry