Provider Demographics
NPI:1760996649
Name:SHULL, RACHEL (ATC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SHULL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:217 MILLWOOD DR APT 7
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-1358
Mailing Address - Country:US
Mailing Address - Phone:760-822-6704
Mailing Address - Fax:
Practice Address - Street 1:3500 MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-1627
Practice Address - Country:US
Practice Address - Phone:510-436-1237
Practice Address - Fax:510-436-1238
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer