Provider Demographics
NPI:1679809891
Name:SLATER, RACHAEL MALENE (DPT)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:MALENE
Last Name:SLATER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RALEY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-8352
Mailing Address - Country:US
Mailing Address - Phone:530-898-0842
Mailing Address - Fax:530-898-0844
Practice Address - Street 1:101 RALEY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-8352
Practice Address - Country:US
Practice Address - Phone:530-898-0842
Practice Address - Fax:530-898-0844
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist