# FAMILY SERVICE AGENCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861561946
- **Authorized official:** MS. RACHELLE AVERBACH IV MFT (PSYCHOTHERAPIST)
- **Authorized official phone:** (415) 453-4662

## Contact information

- **Practice address:** 555 NORTHGATE DR, SAN RAFAEL, CA 94903-3680
- **Practice address phone:** (415) 491-5700
- **Mailing address:** 555 NORTHGATE DR, SAN RAFAEL, CA 94903-3680
- **Mailing address phone:** (415) 491-5700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MFT 23824 | CA | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 07/28/2014