Healthcare Provider Details

I. General information

NPI: 1316568983
Provider Name (Legal Business Name): RACHEL LYNN DENNIS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 FRANKLIN BLVD
LEMOORE CA
93246-2111
US

IV. Provider business mailing address

700 AVENGER NAVAL AIR STATION LEMOORE
LEMOORE CA
93246-5001
US

V. Phone/Fax

Practice location:
  • Phone: 314-225-5059
  • Fax:
Mailing address:
  • Phone: 314-225-5059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0102206743
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number0102206743
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: