Provider Demographics
NPI:1629496104
Name:ALLEN, RACHEL INEZ (CADC I)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:INEZ
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CADC I
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:INEZ
Other - Last Name:HAGGANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC I
Mailing Address - Street 1:1279 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-4134
Mailing Address - Country:US
Mailing Address - Phone:707-464-4813
Mailing Address - Fax:707-465-1442
Practice Address - Street 1:1279 2ND ST
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-4134
Practice Address - Country:US
Practice Address - Phone:707-464-4813
Practice Address - Fax:707-465-1442
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)