Healthcare Provider Details

I. General information

NPI: 1649311275
Provider Name (Legal Business Name): MS. RACHEL ANN COLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. RACHEL ANN BROWN

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 E FOOTHILL BLVD
RIALTO CA
92376-5230
US

IV. Provider business mailing address

850 E FOOTHILL BLVD
RIALTO CA
92376-5230
US

V. Phone/Fax

Practice location:
  • Phone: 909-421-4690
  • Fax: 909-421-5650
Mailing address:
  • Phone: 909-421-4690
  • Fax: 909-421-5650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: