Provider Demographics
NPI:1194305268
Name:BENAVIDEZ, RACHEL (LMFT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BENAVIDEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:STURGEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-9399
Mailing Address - Country:US
Mailing Address - Phone:747-334-2577
Mailing Address - Fax:
Practice Address - Street 1:4619 S RAYMOND RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-9272
Practice Address - Country:US
Practice Address - Phone:747-334-2577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124795101YM0800X
CA139106106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7667OtherMEDICAL
CA7184OtherMEDICAL
CA7708OtherMEDICAL
CA7368OtherMEDICAL