Provider Demographics
NPI:1811761752
Name:HALEY, RACHEL (AMFT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HALEY
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7381 LA TIJERA BLVD
Mailing Address - Street 2:P.O. BOX 452106
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045
Mailing Address - Country:US
Mailing Address - Phone:424-394-1737
Mailing Address - Fax:
Practice Address - Street 1:822 N INGLEWOOD AVE APT 18
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-7768
Practice Address - Country:US
Practice Address - Phone:424-394-1737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141998102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst