Basic Information
| Provider Information | |||||||||
| NPI: | 1699834770 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARRELL | ||||||||
| FirstName: | RACHEL | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1908 N BEALE RD | ||||||||
| Address2: | SUITE E | ||||||||
| City: | MARYSVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959016937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307436888 | ||||||||
| FaxNumber: | 5307439823 | ||||||||
| Practice Location | |||||||||
| Address1: | 1908 N BEALE RD | ||||||||
| Address2: | SUITE E | ||||||||
| City: | MARYSVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959016937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307436888 | ||||||||
| FaxNumber: | 5307439823 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 08/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 176B00000X | 169 | CA | N | Other Service Providers | Midwife | 363A00000X | PA12277 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.