Healthcare Provider Details

I. General information

NPI: 1598201162
Provider Name (Legal Business Name): RACHELLE REBECKA BODLE LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22621 LYONS AVE STE 201
NEWHALL CA
91321-1782
US

IV. Provider business mailing address

22621 LYONS AVE STE 201
NEWHALL CA
91321-1782
US

V. Phone/Fax

Practice location:
  • Phone: 818-326-4558
  • Fax:
Mailing address:
  • Phone: 818-860-2770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number112515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: