MEDICARE: RACHEL GUNTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1225523483	OTHER	CA	1225523483

General Provider Information

NPI Number	:	1548800139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL GUNTER

Provider Business Mailing Address
First Line	:	877 EMBARCADERO DR STE 1
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-1400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1233 HEATHCOT PL
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-5928
Country	:	US
Telephone Number	:	916-693-6369
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2020
Last Update Date	:	01/10/2020

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Directions to “ RACHEL GUNTER ” Practice Location

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