Basic Information
| Provider Information | |||||||||
| NPI: | 1255566618 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RABINOWITZ | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | HERMA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.N. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | RABINOWITZ | ||||||||
| OtherFirstName: | AMY | ||||||||
| OtherMiddleName: | HERMA | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | R.N. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 1330 | ||||||||
| Address2: | |||||||||
| City: | DESERT HOT SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922400943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607736767 | ||||||||
| FaxNumber: | 7607736760 | ||||||||
| Practice Location | |||||||||
| Address1: | 42130 PALM DRIVE | ||||||||
| Address2: | |||||||||
| City: | DESERT HOT SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 992400943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607736767 | ||||||||
| FaxNumber: | 7607736760 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2009 | ||||||||
| LastUpdateDate: | 01/06/2015 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0809X | 742498 | CA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.