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General NPI Number Information
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NPI Number | 1467965533
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Entity Type | Individual
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Provider Name | RACHEL MARIE RYAN
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Gender | Female
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 5150 E PACIFIC COAST HWY
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City | LONG BEACH
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State | CA
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Zip | 90804
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Country | US
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Telephone | 562-490-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 ATLANTIC AVE # 1146
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City | LONG BEACH
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State | CA
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Zip | 90807-4515
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Country | US
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Telephone | 562-246-9606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 101482
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 101482
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License Number State | CA
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