Basic Information
| Provider Information | |||||||||
| NPI: | 1619382140 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HODEL | ||||||||
| FirstName: | RACHELLE | ||||||||
| MiddleName: | SUZANNE REYNOSO | ||||||||
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| OtherLastName: | HODEL | ||||||||
| OtherFirstName: | RACHELLE | ||||||||
| OtherMiddleName: | SUZANNE | ||||||||
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| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1270 NATIVIDAD RD | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939063122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317554510 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1000 S MAIN ST STE 105 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939012394 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317961536 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2014 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 81191 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.