Provider Demographics
NPI:1558958140
Name:MOSOLF, RACHEL MARIANNE (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIANNE
Last Name:MOSOLF
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 BOSTON AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-2906
Mailing Address - Country:US
Mailing Address - Phone:831-901-4987
Mailing Address - Fax:
Practice Address - Street 1:3440 BOSTON AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-2906
Practice Address - Country:US
Practice Address - Phone:831-901-4987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-303629163WL0100X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95158835OtherRN
CAL-303629OtherIBCLE