Basic Information
Provider Information
NPI: 1780010504
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NORTON
FirstName: RACHEL
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6960 DESTINY DR
Address2: #112
City: ROCKLIN
State: CA
PostalCode: 956772993
CountryCode: US
TelephoneNumber: 9164150119
FaxNumber:  
Practice Location
Address1: 6960 DESTINY DR
Address2: #112
City: ROCKLIN
State: CA
PostalCode: 956772993
CountryCode: US
TelephoneNumber: 9164150119
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/25/2013
LastUpdateDate: 08/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X13892CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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