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NPI Code Detail

MEDICARE: RACHEL DIANE MCSPADDEN TARVER MS, LMFT, RPT-S

MEDICARE: RACHEL DIANE MCSPADDEN TARVER MS, LMFT, RPT-S
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
1106H00000XMarriage & Family TherapistMFC 52657CA

General Provider Information

NPI Number : 1922332055
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL DIANE MCSPADDEN TARVER MS, LMFT, RPT-S
Provider Business Mailing Address
First Line : 2180 JOHNSON AVE
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4558
Country : US
Telephone Number : 805-779-0571
Fax Number :
Provider Business Practice Location Address
First Line : 2180 JOHNSON AVE
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4558
Country : US
Telephone Number : 805-779-0571
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2009
Last Update Date : 01/09/2026

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