Healthcare Provider Details

I. General information

NPI: 1285922070
Provider Name (Legal Business Name): RACHEL FROST HOLYBEE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11370 ANDERSON ST STE 3900
LOMA LINDA CA
92354-3450
US

IV. Provider business mailing address

11370 ANDERSON ST STE 3900
LOMA LINDA CA
92354-3450
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-2806
  • Fax:
Mailing address:
  • Phone: 909-558-2806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA21686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: