Healthcare Provider Details

I. General information

NPI: 1386184141
Provider Name (Legal Business Name): RACHEL WEAKLEY LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 02/11/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21612 GOLDEN HILLS BLVD APT A
TEHACHAPI CA
93561-8997
US

IV. Provider business mailing address

20614 OAK PASS AVE
TEHACHAPI CA
93561-6311
US

V. Phone/Fax

Practice location:
  • Phone: 661-805-4164
  • Fax:
Mailing address:
  • Phone: 661-805-4164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number489
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: