Provider Demographics
NPI:1013435130
Name:CALLEJO, RAECHEL LYNNE (LMFT, APCC)
Entity Type:Individual
Prefix:MRS
First Name:RAECHEL
Middle Name:LYNNE
Last Name:CALLEJO
Suffix:
Gender:F
Credentials:LMFT, APCC
Other - Prefix:
Other - First Name:RAECHEL
Other - Middle Name:LYNNE
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PALMER, ALLEN
Mailing Address - Street 1:3330 CHURN CREEK RD STE D4
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-2532
Mailing Address - Country:US
Mailing Address - Phone:530-378-4855
Mailing Address - Fax:530-768-1198
Practice Address - Street 1:3330 CHURN CREEK RD STE D4
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2532
Practice Address - Country:US
Practice Address - Phone:530-378-4855
Practice Address - Fax:530-768-1198
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4308101YP2500X
CA119641106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional