Healthcare Provider Details

I. General information

NPI: 1285213702
Provider Name (Legal Business Name): RACHEL PANDIANGAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 S 5TH ST STE B
COALINGA CA
93210-1903
US

IV. Provider business mailing address

155 S 5TH ST STE B
COALINGA CA
93210-1903
US

V. Phone/Fax

Practice location:
  • Phone: 559-935-4282
  • Fax:
Mailing address:
  • Phone: 559-935-4282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95024572
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: