Provider Demographics
NPI:1669060992
Name:SAMSON, RACHEL TAGUM (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:TAGUM
Last Name:SAMSON
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LAGRIMAS
Other - Last Name:TAGUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:1330 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2634
Mailing Address - Country:US
Mailing Address - Phone:619-208-5568
Mailing Address - Fax:
Practice Address - Street 1:1565 HOTEL CIR S STE 320
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3425
Practice Address - Country:US
Practice Address - Phone:619-450-4414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-03
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily