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General NPI Number Information
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NPI Number | 1730099862
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Entity Type | Individual
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Provider Name | RAYANNE FADICH
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Gender | Female
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 12431 LEWIS ST STE 102
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City | GARDEN GROVE
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State | CA
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Zip | 92840-4653
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Country | US
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Telephone | 657-452-6811
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Fax |
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Provider Business Mailing Address
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Address Line | 6740 LOS VERDES DR APT 3
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-5562
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Country | US
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Telephone | 310-933-2216
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | CA
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