Provider Demographics
NPI:1164107967
Name:PATEL, RAQUEL (FNP)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:PATEL
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 1:12417 FAIR OAKS BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-2500
Mailing Address - Country:US
Mailing Address - Phone:916-727-1400
Mailing Address - Fax:916-727-1403
Practice Address - Street 1:12417 FAIR OAKS BLVD STE 600
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-2500
Practice Address - Country:US
Practice Address - Phone:916-727-1400
Practice Address - Fax:916-727-1403
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023550363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily