Healthcare Provider Details

I. General information

NPI: 1821307117
Provider Name (Legal Business Name): RACHEL DAGGETT LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 PACIFIC COAST HWY STE 107
HERMOSA BEACH CA
90254-2734
US

IV. Provider business mailing address

2401 PACIFIC COAST HWY STE 107
HERMOSA BEACH CA
90254-2734
US

V. Phone/Fax

Practice location:
  • Phone: 310-697-6728
  • Fax:
Mailing address:
  • Phone: 310-697-6728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: