Provider Demographics
NPI:1649587916
Name:SASSER, RAECHAEL MARIE
Entity Type:Individual
Prefix:
First Name:RAECHAEL
Middle Name:MARIE
Last Name:SASSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21081 S WESTERN AVE
Mailing Address - Street 2:#295
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1703
Mailing Address - Country:US
Mailing Address - Phone:310-533-6600
Mailing Address - Fax:
Practice Address - Street 1:21081 S. WESTERN AVENUE
Practice Address - Street 2:#295
Practice Address - City:TORRAMCE
Practice Address - State:CA
Practice Address - Zip Code:90501
Practice Address - Country:US
Practice Address - Phone:310-533-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health