Provider Demographics
NPI:1245256619
Name:RAPPE, SANDRA L (LCSW)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:L
Last Name:RAPPE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FELIZ DR
Mailing Address - Street 2:
Mailing Address - City:OAK VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:93022-9517
Mailing Address - Country:US
Mailing Address - Phone:805-649-1518
Mailing Address - Fax:
Practice Address - Street 1:1304 E MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-3202
Practice Address - Country:US
Practice Address - Phone:805-320-9140
Practice Address - Fax:805-641-3901
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS105261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR36378Medicare UPIN