Provider Demographics
NPI:1619550035
Name:SAMUELS, RACHEL (LMFT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SAMUELS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2677 N MAIN ST STE 130
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-6665
Mailing Address - Country:US
Mailing Address - Phone:714-551-7077
Mailing Address - Fax:
Practice Address - Street 1:1025 S HOLT AVE APT 304
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2050
Practice Address - Country:US
Practice Address - Phone:408-440-6265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-03
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109125101YM0800X
CA136623106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty