Provider Demographics
NPI:1962200915
Name:RATHORE, MAHIP (PHD)
Entity type:Individual
Prefix:
First Name:MAHIP
Middle Name:
Last Name:RATHORE
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 STATE ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3301
Mailing Address - Country:US
Mailing Address - Phone:424-234-1620
Mailing Address - Fax:
Practice Address - Street 1:615 STATE ST UNIT B
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3301
Practice Address - Country:US
Practice Address - Phone:424-234-1620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY35728103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling