Provider Demographics
NPI:1720116585
Name:ANDERSON, ANN RACHEL (MFT)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:RACHEL
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4285 EXCELSIOR RD
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-7910
Mailing Address - Country:US
Mailing Address - Phone:707-445-8625
Mailing Address - Fax:
Practice Address - Street 1:2625 WILSON ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4829
Practice Address - Country:US
Practice Address - Phone:707-298-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41866106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist