Provider Demographics
NPI:1649370826
Name:DEZEMBER, RACHEL PIAZZA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:PIAZZA
Last Name:DEZEMBER
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 1:300 RANCHEROS DR STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2968
Mailing Address - Country:US
Mailing Address - Phone:858-279-1223
Mailing Address - Fax:
Practice Address - Street 1:300 RANCHEROS DR STE 130
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2968
Practice Address - Country:US
Practice Address - Phone:760-420-9178
Practice Address - Fax:760-730-3933
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 234761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical