Provider Demographics
NPI:1457785495
Name:GRIEF, RACHEL JULIA
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JULIA
Last Name:GRIEF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 VENEZIA LN
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-1767
Mailing Address - Country:US
Mailing Address - Phone:480-577-3500
Mailing Address - Fax:
Practice Address - Street 1:17609 VENTURA BLVD STE 215
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-5126
Practice Address - Country:US
Practice Address - Phone:818-800-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8482235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA272115023OtherEIN