Provider Demographics
NPI:1053723932
Name:SHAPIRA, RACHEL (SCM, LCGC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SHAPIRA
Suffix:
Gender:F
Credentials:SCM, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 CHARLES YOUNG DR S
Mailing Address - Street 2:ROOM A2-125 CHS BOX 95690
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-6900
Mailing Address - Country:US
Mailing Address - Phone:310-794-7576
Mailing Address - Fax:310-206-3566
Practice Address - Street 1:650 CHARLES YOUNG DR S
Practice Address - Street 2:ROOM A2-125 CHS BOX 95690
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-6900
Practice Address - Country:US
Practice Address - Phone:310-794-7576
Practice Address - Fax:310-206-3566
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000535170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS