Healthcare Provider Details

I. General information

NPI: 1104758903
Provider Name (Legal Business Name): RACHEL DIXON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9346 VIA BRITTNEY
LAKESIDE CA
92040-3644
US

IV. Provider business mailing address

9346 VIA BRITTNEY
LAKESIDE CA
92040-3644
US

V. Phone/Fax

Practice location:
  • Phone: 702-338-3397
  • Fax:
Mailing address:
  • Phone: 702-338-3397
  • Fax: 702-338-3397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number48758
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: