Provider Demographics
NPI:1366636847
Name:SUMAQUIAL, RACHEL ABELLA (RACHEL SUMAQUIAL, PA)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ABELLA
Last Name:SUMAQUIAL
Suffix:
Gender:F
Credentials:RACHEL SUMAQUIAL, PA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ABELLA
Other - Last Name:SUMAQUIAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RACHEL SUMAQUIAL, PA
Mailing Address - Street 1:866 SCHMIDT CT
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-4351
Mailing Address - Country:US
Mailing Address - Phone:209-598-3218
Mailing Address - Fax:
Practice Address - Street 1:3601 BROOKSIDE ROAD
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95211-0001
Practice Address - Country:US
Practice Address - Phone:209-946-2315
Practice Address - Fax:209-946-3001
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19194363A00000X
CA17129363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily