Individual provider Active NPI

Rehana Raheem, PSY. D.

  • Clinical Psychologist
  • Walnut Creek, CA
National Provider Identifier
1285141960
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY35625 Issued in CA
Practice address
1840 San Miguel Dr
Walnut Creek, CA 94596-8602
Phone
(510) 520-0394
NPI assigned
Jan 4, 2018
Reactivated
Apr 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY35625 CA Primary

Addresses

Primary practice location

1840 San Miguel Dr
Walnut Creek, CA 94596-8602

Mailing address

6363 Christie Ave Apt 2415
Emeryville, CA 94608-1948
Phone (510) 520-0394

Other practice location 1

6363 Christie Ave Apt 2415
Emeryville, CA 94608-1948
Phone (510) 520-0394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY35625CAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1285141960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6363 CHRISTIE AVE APT 2415",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081948",
            "telephone_number": "510-520-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 SAN MIGUEL DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945968602",
            "telephone_number": "510-520-0394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6363 Christie Ave Apt 2415",
            "address_purpose": "LOCATION",
            "city": "Emeryville",
            "state": "CA",
            "postal_code": "946081948",
            "country_code": "US",
            "telephone_number": "510-520-0394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHEEM",
        "first_name": "REHANA",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "deactivation_date": "2018-08-22",
        "reactivation_date": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.