Basic Information
| Provider Information | |||||||||
| NPI: | 1952513756 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOOD | ||||||||
| FirstName: | RAELEE | ||||||||
| MiddleName: | ELBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13128 CULLEN ST | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906023036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626862553 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1060 S BROOKHURST RD | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928333709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144491339 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2007 | ||||||||
| LastUpdateDate: | 02/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 112494 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.