Provider Demographics
NPI:1881901460
Name:PEPPER, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PEPPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 WASHINGTON ST STE 213
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-3924
Mailing Address - Country:US
Mailing Address - Phone:510-359-8756
Mailing Address - Fax:510-201-2491
Practice Address - Street 1:725 WASHINGTON ST STE 213
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-3924
Practice Address - Country:US
Practice Address - Phone:510-359-8756
Practice Address - Fax:510-201-2491
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83511106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist