Healthcare Provider Details

I. General information

NPI: 1306501606
Provider Name (Legal Business Name): RACHEL CAROLINE HEUSSNER ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2021
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 STATE ST UNIT 101
SAN DIEGO CA
92101-1315
US

IV. Provider business mailing address

1644 DIAMOND ST
SAN DIEGO CA
92109-3143
US

V. Phone/Fax

Practice location:
  • Phone: 619-933-2340
  • Fax:
Mailing address:
  • Phone: 609-276-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND1292
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: