Healthcare Provider Details

I. General information

NPI: 1184359184
Provider Name (Legal Business Name): RACHEL MCKENZIE HAASE PMHNP-DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3095 TELEGRAPH AVE
BERKELEY CA
94705-2035
US

IV. Provider business mailing address

1015 NE KAYAK LOOP UNIT B
BEND OR
97701-6886
US

V. Phone/Fax

Practice location:
  • Phone: 832-869-4818
  • Fax:
Mailing address:
  • Phone: 425-773-8656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number202210453NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: