Provider Demographics
NPI:1326117920
Name:KROCHMAL, RACHEL ELIZABETH (FNP/PA-C)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:KROCHMAL
Suffix:
Gender:F
Credentials:FNP/PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 E VALLEY PKWY STE 311
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3374
Mailing Address - Country:US
Mailing Address - Phone:760-746-2860
Mailing Address - Fax:760-738-9501
Practice Address - Street 1:488 E VALLEY PKWY STE 311
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3374
Practice Address - Country:US
Practice Address - Phone:760-746-2860
Practice Address - Fax:760-738-9501
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN457272363LF0000X
CA52203363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS67002Medicare UPIN
CAS67002Medicare UPIN