Doctor Name: | PHILLIP G RACIES |
NPI Number: | 1689715666 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, MFTI |
License Number: | |
Business Practice Address: | 171 Carlos Dr San Rafael, CA - 949032005 |
Business Phone Number: | 4154445580 |
Business Fax Number: | 4154445598 |
Mailing Address: | 120 D St Apt 1, SAN RAFAEL |
State: | CA |
Postal Code: | 949015026 |
Phone Number: | 4156869822 |
Fax Number: | 4154445598 |
NPI Enumeration Date: | 02/10/2007 |
NPI Last Update Date: | 06/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |