Provider Demographics
NPI:1811306079
Name:ROSSETTO, RACHEL KEI (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:KEI
Last Name:ROSSETTO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:KEI
Other - Last Name:NISHIMOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:568 N SUNRISE AVE
Practice Address - Street 2:100
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3097
Practice Address - Country:US
Practice Address - Phone:916-865-1100
Practice Address - Fax:916-865-1105
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41066225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist