Healthcare Provider Details

I. General information

NPI: 1225416449
Provider Name (Legal Business Name): RACHELLE R. JOHNSON N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 MARINA WAY S STE G
RICHMOND CA
94804-3769
US

IV. Provider business mailing address

951 MARINA WAY S STE G
RICHMOND CA
94804-3769
US

V. Phone/Fax

Practice location:
  • Phone: 415-523-9409
  • Fax: 510-255-6066
Mailing address:
  • Phone: 415-523-9409
  • Fax: 510-255-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License NumberND737
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND737
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: