MEDICARE: RACHEL MOLLY HIRSHBERG ASW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1811667819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL MOLLY HIRSHBERG ASW

Provider Business Mailing Address
First Line	:	1313 SPRUCE ST
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-4431
Country	:	US
Telephone Number	:	650-933-8002
Fax Number	:

Provider Business Practice Location Address
First Line	:	2235 LAKE AVE
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-2465
Country	:	US
Telephone Number	:	626-486-2167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2021
Last Update Date	:	09/20/2021

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