Healthcare Provider Details

I. General information

NPI: 1164044616
Provider Name (Legal Business Name): RACHEL GAYLE LAMBERT LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL GAYLE PARK LMFT

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 05/07/2020
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 KIAWAH RIVER DR
OXNARD CA
93036-5321
US

IV. Provider business mailing address

335 KIAWAH RIVER DR
OXNARD CA
93036-5321
US

V. Phone/Fax

Practice location:
  • Phone: 805-401-3258
  • Fax:
Mailing address:
  • Phone: 805-401-3258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number93636
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: