Healthcare Provider Details

I. General information

NPI: 1730054875
Provider Name (Legal Business Name): RACHEL WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 LOMA VISTA RD STE C
VENTURA CA
93003-3165
US

IV. Provider business mailing address

1203 FLYNN RD UNIT 160
CAMARILLO CA
93012-6203
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6955
  • Fax: 805-652-6959
Mailing address:
  • Phone: 805-804-4168
  • Fax: 805-830-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number309422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: