Provider Demographics
NPI:1629587068
Name:KING, RACHEL ELIZABETH (OTR/L, MS)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:KING
Suffix:
Gender:F
Credentials:OTR/L, MS
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:ELIZABETH
Other - Last Name:EAKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L, MS
Mailing Address - Street 1:320 TESCONI CIR
Mailing Address - Street 2:SUITE G
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4611
Mailing Address - Country:US
Mailing Address - Phone:707-544-2637
Mailing Address - Fax:707-544-2088
Practice Address - Street 1:320 TESCONI CIR STE G
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4611
Practice Address - Country:US
Practice Address - Phone:707-544-2637
Practice Address - Fax:707-544-2088
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT16281225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation