Healthcare Provider Details

I. General information

NPI: 1326580937
Provider Name (Legal Business Name): RINA RASMUSSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2016
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9720 KIOWA RD
APPLE VALLEY CA
92308-8628
US

IV. Provider business mailing address

9720 KIOWA RD
APPLE VALLEY CA
92308-8628
US

V. Phone/Fax

Practice location:
  • Phone: 562-233-5622
  • Fax:
Mailing address:
  • Phone: 562-233-5622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-15-20238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: