Provider Demographics
NPI:1275028110
Name:ELUL-JONES, RACHELLE (PEDIATRIC NP)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:ELUL-JONES
Suffix:
Gender:F
Credentials:PEDIATRIC NP
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:
Other - Last Name:ELUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1204 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1505
Mailing Address - Country:US
Mailing Address - Phone:415-595-5459
Mailing Address - Fax:
Practice Address - Street 1:1518 NORIEGA ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-4434
Practice Address - Country:US
Practice Address - Phone:415-595-5459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-23
Last Update Date:2018-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF95005690363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANPF95005690OtherNP LICENSE #