Healthcare Provider Details

I. General information

NPI: 1043993983
Provider Name (Legal Business Name): RACHEL LIPPMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6147 SUTTER AVE
CARMICHAEL CA
95608-2738
US

IV. Provider business mailing address

4140 62ND ST
SACRAMENTO CA
95820-3240
US

V. Phone/Fax

Practice location:
  • Phone: 916-971-7640
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT148114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: