Healthcare Provider Details

I. General information

NPI: 1831522861
Provider Name (Legal Business Name): RACHEL MICHELLE WARREN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 1ST ST
WOODLAND CA
95695-4023
US

IV. Provider business mailing address

500 JEFFERSON BLVD STE 195
WEST SACRAMENTO CA
95605-2350
US

V. Phone/Fax

Practice location:
  • Phone: 530-662-2211
  • Fax:
Mailing address:
  • Phone: 916-538-9883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number94737
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number117866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: