Provider Demographics
NPI:1922154434
Name:GEISSLER, RAINER (MA)
Entity Type:Individual
Prefix:MR
First Name:RAINER
Middle Name:
Last Name:GEISSLER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S LOS ANGELES ST # A409
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3791
Mailing Address - Country:US
Mailing Address - Phone:415-999-1049
Mailing Address - Fax:213-266-8310
Practice Address - Street 1:200 S LOS ANGELES ST # A409
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3791
Practice Address - Country:US
Practice Address - Phone:415-999-1049
Practice Address - Fax:213-266-8310
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48467101YA0400X, 101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health