Provider Demographics
NPI:1548631260
Name:STANDLEY, RACHEL (LPCC13971)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:STANDLEY
Suffix:
Gender:F
Credentials:LPCC13971
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8017 EL CAJON ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-3725
Mailing Address - Country:US
Mailing Address - Phone:510-395-2755
Mailing Address - Fax:510-487-2916
Practice Address - Street 1:8017 EL CAJON ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210
Practice Address - Country:US
Practice Address - Phone:510-395-2755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC13971101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional