Healthcare Provider Details

I. General information

NPI: 1144082769
Provider Name (Legal Business Name): RACHEL DERBY AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 BIDWELL ST
FOLSOM CA
95630-3039
US

IV. Provider business mailing address

3385 BASS LAKE RD STE 100
EL DORADO HILLS CA
95762-6637
US

V. Phone/Fax

Practice location:
  • Phone: 916-237-7042
  • Fax:
Mailing address:
  • Phone: 408-469-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT159689
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: