Provider Demographics
NPI:1972869915
Name:CHESTNUT, RACHEL ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:CHESTNUT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BROOKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95007
Mailing Address - Country:US
Mailing Address - Phone:831-535-2628
Mailing Address - Fax:
Practice Address - Street 1:2001 RIVER RD
Practice Address - Street 2:
Practice Address - City:BROOKDALE
Practice Address - State:CA
Practice Address - Zip Code:95007
Practice Address - Country:US
Practice Address - Phone:831-535-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA813269163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health