Provider Demographics
NPI:1205405198
Name:WILLIAMS, RACHEL (OT/L)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 E DEEPVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-3469
Mailing Address - Country:US
Mailing Address - Phone:951-452-3636
Mailing Address - Fax:
Practice Address - Street 1:1022 E DEEPVIEW DR
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-3469
Practice Address - Country:US
Practice Address - Phone:951-452-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT3002225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist