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General NPI Number Information
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NPI Number | 1700555802
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Entity Type | Individual
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Provider Name | RACHAEL MARIE RENTON NP
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Gender | Female
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Dates
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Enumeration Date | 09/10/2021
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 291 SMITH RANCH RD
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City | SAN RAFAEL
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State | CA
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Zip | 94903-2093
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Country | US
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Telephone | 415-457-6964
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 WEBSTER ST APT 868
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City | OAKLAND
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State | CA
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Zip | 94607-4651
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Country | US
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Telephone | 818-601-5398
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95018362
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License Number State | CA
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