Provider Demographics
NPI:1295453033
Name:GOVETT, RACHEL E (OTR/L)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:GOVETT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:E
Other - Last Name:MOONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:2045 MARIPOSA DR
Mailing Address - Street 2:
Mailing Address - City:HUGHSON
Mailing Address - State:CA
Mailing Address - Zip Code:95326-9198
Mailing Address - Country:US
Mailing Address - Phone:209-648-3628
Mailing Address - Fax:
Practice Address - Street 1:2121 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2012
Practice Address - Country:US
Practice Address - Phone:209-664-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-18
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1215225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist