Healthcare Provider Details

I. General information

NPI: 1588334973
Provider Name (Legal Business Name): RACHELLE PACE DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35000 GUADALCANAL ST
SAN DIEGO CA
92140-5599
US

IV. Provider business mailing address

3800 CHOSIN AVE
SAN DIEGO CA
92140-5196
US

V. Phone/Fax

Practice location:
  • Phone: 619-524-4051
  • Fax:
Mailing address:
  • Phone: 619-524-4051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95026070
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: