Healthcare Provider Details

I. General information

NPI: 1497006464
Provider Name (Legal Business Name): RACHEL DISKIN LYNCH RN, PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2012
Last Update Date: 07/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 CHURCH ST
SAN FRANCISCO CA
94131-2412
US

IV. Provider business mailing address

1701 CHURCH ST
SAN FRANCISCO CA
94131-2412
US

V. Phone/Fax

Practice location:
  • Phone: 571-217-5361
  • Fax:
Mailing address:
  • Phone: 415-826-1701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number22985
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number831913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: