Provider Demographics
NPI:1275024549
Name:NEAL, RACHEL ELISA
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELISA
Last Name:NEAL
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 1:3182 KAYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-8411
Mailing Address - Country:US
Mailing Address - Phone:619-554-4852
Mailing Address - Fax:
Practice Address - Street 1:3182 KAYWOOD DR
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-8411
Practice Address - Country:US
Practice Address - Phone:619-558-4592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9163WM0705X
CA95163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical