Provider Demographics
NPI:1831524750
Name:PARKER, RACHELLE
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6753 RIDGESIDE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4929
Mailing Address - Country:US
Mailing Address - Phone:951-212-9218
Mailing Address - Fax:833-341-1902
Practice Address - Street 1:6753 RIDGESIDE DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4929
Practice Address - Country:US
Practice Address - Phone:951-212-9218
Practice Address - Fax:833-341-1902
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA224090164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse