Healthcare Provider Details

I. General information

NPI: 1073141925
Provider Name (Legal Business Name): RACHEL N. NIEZRECKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 18TH ST
SAN FRANCISCO CA
94143-4200
US

IV. Provider business mailing address

2211 POST ST STE 200
SAN FRANCISCO CA
94115-3467
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-7000
  • Fax:
Mailing address:
  • Phone: 415-928-1221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number12420082-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA196585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: