Provider Demographics
NPI:1720254717
Name:ZEPEDA, RACHAEL (CMTQ)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:ZEPEDA
Suffix:
Gender:F
Credentials:CMTQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2733
Mailing Address - Country:US
Mailing Address - Phone:925-957-6570
Mailing Address - Fax:925-687-1624
Practice Address - Street 1:3100 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2733
Practice Address - Country:US
Practice Address - Phone:925-957-6570
Practice Address - Fax:925-687-1624
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0703021225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist