Provider Demographics
NPI:1588115182
Name:MCNALLY, RACHEL (LAC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:FOERSTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7655 WINNETKA AVE UNIT 2341
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91396-7020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5363 BALBOA BLVD STE 436
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2840
Practice Address - Country:US
Practice Address - Phone:818-237-3635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16928171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist