Provider Demographics
NPI:1568849057
Name:ROOT, RACHEL (LAC)
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:
Last Name:ROOT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 MARIPOSA ST
Mailing Address - Street 2:APT 5
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-2453
Mailing Address - Country:US
Mailing Address - Phone:480-242-4996
Mailing Address - Fax:
Practice Address - Street 1:1335 MARIPOSA ST
Practice Address - Street 2:APT 5
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-2453
Practice Address - Country:US
Practice Address - Phone:480-242-4996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist