Provider Demographics
NPI:1972882272
Name:SPENCER, RACHEL C (MFT)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:C
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 SANTA MONICA BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-5970
Mailing Address - Country:US
Mailing Address - Phone:310-499-1462
Mailing Address - Fax:
Practice Address - Street 1:8235 SANTA MONICA BLVD STE 400
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-5970
Practice Address - Country:US
Practice Address - Phone:310-499-1462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45518106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist