Provider Demographics
NPI:1982937892
Name:BERG-MARTINEZ, RACHAEL D (PHD, PMH-C)
Entity type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:D
Last Name:BERG-MARTINEZ
Suffix:
Gender:F
Credentials:PHD, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 S OLD SPRINGS RD STE 135
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-1285
Mailing Address - Country:US
Mailing Address - Phone:657-215-7374
Mailing Address - Fax:
Practice Address - Street 1:160 S OLD SPRINGS RD STE 135
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-1285
Practice Address - Country:US
Practice Address - Phone:657-215-7374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301019003103TC0700X
CAPSY26730103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical