Healthcare Provider Details

I. General information

NPI: 1730998147
Provider Name (Legal Business Name): RACHEL GOLDBERG INDIVIDUAL & FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2025
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11712 MOORPARK ST STE 111
STUDIO CITY CA
91604-2163
US

IV. Provider business mailing address

11712 MOORPARK ST STE 111
STUDIO CITY CA
91604-2163
US

V. Phone/Fax

Practice location:
  • Phone: 424-245-0223
  • Fax:
Mailing address:
  • Phone: 424-245-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RACHEL GOLDBERG
Title or Position: FOUNDER
Credential: LMFT
Phone: 424-245-0223