Provider Demographics
NPI:1104393008
Name:WEDDLE, RACHEL
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WEDDLE
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 1:4987 GOLDEN FOOTHILL PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9364
Mailing Address - Country:US
Mailing Address - Phone:916-365-2411
Mailing Address - Fax:
Practice Address - Street 1:4987 GOLDEN FOOTHILL PKWY STE 100
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9364
Practice Address - Country:US
Practice Address - Phone:916-365-2411
Practice Address - Fax:916-404-0322
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD3046084225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist