Healthcare Provider Details

I. General information

NPI: 1700087293
Provider Name (Legal Business Name): RACHELLE GOERING FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125B CAMINO ALTO
MILL VALLEY CA
94941-4601
US

IV. Provider business mailing address

3260 BEARD RD 3
NAPA CA
94558-3466
US

V. Phone/Fax

Practice location:
  • Phone: 415-383-9903
  • Fax: 415-383-9901
Mailing address:
  • Phone: 707-255-4172
  • Fax: 888-315-3813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number525495
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: