Provider Demographics
NPI:1205367562
Name:RACHEL VON DOEPP CD, CLE
Entity Type:Organization
Organization Name:RACHEL VON DOEPP CD, CLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SELF EMPLOYEED
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VON DOEPP
Authorized Official - Suffix:
Authorized Official - Credentials:CD, CLE
Authorized Official - Phone:415-451-1845
Mailing Address - Street 1:60 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3654
Mailing Address - Country:US
Mailing Address - Phone:415-451-1845
Mailing Address - Fax:
Practice Address - Street 1:60 CLARK ST
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3654
Practice Address - Country:US
Practice Address - Phone:415-451-1845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health