Provider Demographics
NPI:1619382140
Name:HODEL, RACHELLE SUZANNE REYNOSO
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:SUZANNE REYNOSO
Last Name:HODEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:SUZANNE
Other - Last Name:HODEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1270 NATIVIDAD RD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3122
Mailing Address - Country:US
Mailing Address - Phone:831-755-4510
Mailing Address - Fax:
Practice Address - Street 1:1000 S MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2394
Practice Address - Country:US
Practice Address - Phone:831-796-1536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA811911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical