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General NPI Number Information
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NPI Number | 1811211691
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Entity Type | Individual
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Provider Name | RACHEL M MICKEL LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 10/30/2021
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Provider Practice Location Address
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Address Line | 9135 ARCHIBALD AVE STE B
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5227
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Country | US
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Telephone | 213-444-7334
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Fax |
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Provider Business Mailing Address
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Address Line | 2420 RIVER RD STE 230-824
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City | NORCO
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State | CA
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Zip | 92860-2268
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Country | US
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Telephone | 213-444-7334
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | M7600
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License Number State | MS
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