MEDICARE: DR. RACHEL WOLFE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	291981	CA

General Provider Information

NPI Number	:	1033666326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL WOLFE DPT

Provider Business Mailing Address
First Line	:	1115 SIR FRANCIS DRAKE BLVD APT 22
Second Line	:
City	:	KENTFIELD
State	:	CA
Zip	:	94904-1431
Country	:	US
Telephone Number	:	727-271-0386
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 N SAN PEDRO RD
Second Line	:	3RD FLOOR
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903-4213
Country	:	US
Telephone Number	:	415-491-4751
Fax Number	:	415-491-4754

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2016
Last Update Date	:	12/30/2021

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