Basic Information
| Provider Information | |||||||||
| NPI: | 1710064480 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAHEL-AHMADZAI | ||||||||
| FirstName: | SONIA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1561 | ||||||||
| Address2: | |||||||||
| City: | PLACERVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956671561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164351414 | ||||||||
| FaxNumber: | 5306222793 | ||||||||
| Practice Location | |||||||||
| Address1: | 3101 SUNSET BLVD STE 6C | ||||||||
| Address2: | |||||||||
| City: | ROCKLIN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956773089 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164351414 | ||||||||
| FaxNumber: | 5306222793 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC37247 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.