Provider Demographics
NPI:1396977153
Name:HAKAK, RASHELLE RENTYA (MA)
Entity type:Individual
Prefix:
First Name:RASHELLE
Middle Name:RENTYA
Last Name:HAKAK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 927994
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92192-7994
Mailing Address - Country:US
Mailing Address - Phone:310-488-1634
Mailing Address - Fax:
Practice Address - Street 1:26137 LA PAZ RD
Practice Address - Street 2:230
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5319
Practice Address - Country:US
Practice Address - Phone:949-595-8610
Practice Address - Fax:949-595-0296
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health