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General NPI Number Information
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NPI Number | 1174320444
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Entity Type | Individual
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Provider Name | RAQUEL MARIE LOVE
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Gender | Female
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 5007 KENNETH AVE
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City | FAIR OAKS
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State | CA
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Zip | 95628-5329
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Country | US
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Telephone | 530-746-1512
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 DATA DR APT 449
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-7932
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Country | US
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Telephone | 916-796-2223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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