Provider Demographics
NPI:1124139381
Name:AMINI, RACHELLE LOUISE (PSYD, MSW)
Entity type:Individual
Prefix:MISS
First Name:RACHELLE
Middle Name:LOUISE
Last Name:AMINI
Suffix:
Gender:F
Credentials:PSYD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 BEECH ST UNIT 1801
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-0807
Mailing Address - Country:US
Mailing Address - Phone:858-610-1490
Mailing Address - Fax:
Practice Address - Street 1:1870 CORDELL CT STE 101
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-0915
Practice Address - Country:US
Practice Address - Phone:619-448-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22086103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8299OtherUBH