Healthcare Provider Details

I. General information

NPI: 1205053972
Provider Name (Legal Business Name): DAVID ARNOT RASCH PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 PARK BLVD
PALO ALTO CA
94306-1924
US

IV. Provider business mailing address

27200 PRADO DEL SOL
CARMEL CA
93923-9526
US

V. Phone/Fax

Practice location:
  • Phone: 650-799-1569
  • Fax:
Mailing address:
  • Phone: 650-799-1569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY13027
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: