Healthcare Provider Details

I. General information

NPI: 1235073933
Provider Name (Legal Business Name): RACHEL LEIGH TRIBBLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8708 DALLAS ST
LA MESA CA
91942-3201
US

IV. Provider business mailing address

8708 DALLAS ST
LA MESA CA
91942-3201
US

V. Phone/Fax

Practice location:
  • Phone: 619-432-8010
  • Fax:
Mailing address:
  • Phone: 619-432-8010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: RACHEL LEIGH TRIBBLE
Title or Position: OWNER
Credential: LCSW 102147
Phone: 619-432-8010