Provider Demographics
NPI:1710441167
Name:WEGENER, RACHAEL JENE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:JENE
Last Name:WEGENER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:230 CALIFORNIA AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1637
Mailing Address - Country:US
Mailing Address - Phone:510-828-3389
Mailing Address - Fax:669-267-1070
Practice Address - Street 1:230 CALIFORNIA AVE STE 205
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1637
Practice Address - Country:US
Practice Address - Phone:408-256-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1016251041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical