Provider Demographics
NPI:1003573585
Name:EMMER, RACHEL LEA
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEA
Last Name:EMMER
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 1:3024 CAMINO CIELO
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-9668
Mailing Address - Country:US
Mailing Address - Phone:713-303-0648
Mailing Address - Fax:
Practice Address - Street 1:3024 CAMINO CIELO
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-9668
Practice Address - Country:US
Practice Address - Phone:713-303-0648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102843235Z00000X
CA29573235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist