Healthcare Provider Details

I. General information

NPI: 1497312722
Provider Name (Legal Business Name): RACHEL ALAYNE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL ALAYNE CAYNAK

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MISSION BLVD
JACKSON CA
95642-2536
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 209-257-1722
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA191509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: