Healthcare Provider Details

I. General information

NPI: 1164048278
Provider Name (Legal Business Name): RACHEL SHALEV
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 FILLMORE ST STE 216
SAN FRANCISCO CA
94115-4164
US

IV. Provider business mailing address

119 WILLIAMS LN
FOSTER CITY CA
94404-3969
US

V. Phone/Fax

Practice location:
  • Phone: 858-210-2386
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: