Provider Demographics
NPI:1093161705
Name:BIVENS, RACHEL DENICE (LMFT# 140327)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:DENICE
Last Name:BIVENS
Suffix:
Gender:F
Credentials:LMFT# 140327
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:DENICE
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1008 W AVENUE M14 STE A-D647
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1441
Mailing Address - Country:US
Mailing Address - Phone:310-693-1707
Mailing Address - Fax:
Practice Address - Street 1:1008 W AVENUE M14 STE A-D647
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1441
Practice Address - Country:US
Practice Address - Phone:310-693-1707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA140327106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor