Provider Demographics
NPI:1487496501
Name:PAUL, RACHEL (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 FLORECITA DR
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-4121
Mailing Address - Country:US
Mailing Address - Phone:917-841-0805
Mailing Address - Fax:
Practice Address - Street 1:3225 FLORECITA DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-4121
Practice Address - Country:US
Practice Address - Phone:917-841-0805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95293310163W00000X
CAL-311612163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse