Healthcare Provider Details

I. General information

NPI: 1699491944
Provider Name (Legal Business Name): RACHEL PETERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3840 ROSIN CT STE 100
SACRAMENTO CA
95834-1645
US

IV. Provider business mailing address

3840 ROSIN CT STE 100
SACRAMENTO CA
95834-1645
US

V. Phone/Fax

Practice location:
  • Phone: 916-921-0828
  • Fax:
Mailing address:
  • Phone: 916-921-0828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number88854E9550
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: