Provider Demographics
NPI:1487288726
Name:WILLARD, RACHEL LYNN
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:WILLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 CHELSEA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-1614
Mailing Address - Country:US
Mailing Address - Phone:707-640-5429
Mailing Address - Fax:
Practice Address - Street 1:149 CHELSEA HILLS DR
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-1614
Practice Address - Country:US
Practice Address - Phone:707-640-5429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)