Provider Demographics
NPI:1689347205
Name:RAJENDRAN, REHA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:REHA
Middle Name:
Last Name:RAJENDRAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 DOANE ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-5943
Mailing Address - Country:US
Mailing Address - Phone:862-812-6008
Mailing Address - Fax:
Practice Address - Street 1:4502 DOANE ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-5943
Practice Address - Country:US
Practice Address - Phone:862-324-5474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor