Healthcare Provider Details

I. General information

NPI: 1740769959
Provider Name (Legal Business Name): RACHEL RAVER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 ALPINE BLVD
ALPINE CA
91901-2113
US

IV. Provider business mailing address

104 E 9TH AVE
ESCONDIDO CA
92025-5153
US

V. Phone/Fax

Practice location:
  • Phone: 619-445-2644
  • Fax:
Mailing address:
  • Phone: 330-618-6044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number34354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: