Provider Demographics
NPI:1689827495
Name:LORAH, RITA FRANCES (ASW)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:FRANCES
Last Name:LORAH
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 MCHENRY AVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4500
Mailing Address - Country:US
Mailing Address - Phone:209-557-6200
Mailing Address - Fax:209-557-6213
Practice Address - Street 1:1524 MCHENRY AVE
Practice Address - Street 2:SUITE 450
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4500
Practice Address - Country:US
Practice Address - Phone:209-557-6200
Practice Address - Fax:209-557-6213
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 25596101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAASW 25596OtherVETERANS ADMINISTRATION HEALTH CARE PROVIDER