Provider Demographics
NPI:1558623678
Name:TAMAGNI, RACHEL LYNN
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:TAMAGNI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LYNN
Other - Last Name:CANNON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CMP
Mailing Address - Street 1:1632 CHRISTINA CT
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-7148
Mailing Address - Country:US
Mailing Address - Phone:805-769-6808
Mailing Address - Fax:805-227-4761
Practice Address - Street 1:1632 CHRISTINA CT
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-7148
Practice Address - Country:US
Practice Address - Phone:805-769-6808
Practice Address - Fax:805-227-4761
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24923173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist