Provider Demographics
NPI:1801369251
Name:SALUNGA, RACHELLE MEGAN (FNP)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:MEGAN
Last Name:SALUNGA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 W 190TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5513
Mailing Address - Country:US
Mailing Address - Phone:424-314-0203
Mailing Address - Fax:
Practice Address - Street 1:625 S FAIR OAKS AVE STE 345
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2677
Practice Address - Country:US
Practice Address - Phone:424-314-0203
Practice Address - Fax:424-314-0206
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010713363LF0000X, 364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily