Healthcare Provider Details

I. General information

NPI: 1386569622
Provider Name (Legal Business Name): RACHEL LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3960 WALNUT DR
EUREKA CA
95503-8938
US

IV. Provider business mailing address

1949 HAEGER AVE
ARCATA CA
95521-5426
US

V. Phone/Fax

Practice location:
  • Phone: 707-268-8722
  • Fax:
Mailing address:
  • Phone: 630-460-0927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: