MEDICARE: BETH RAKOWER NP

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	363LF0000X	Family Nurse Practitioner	756686	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235164450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH RAKOWER NP

Provider Business Mailing Address
First Line	:	2344 6TH STREET
Second Line	:	ATTENTION: CREDENTIALING DEPT.
City	:	BERKELEY
State	:	CA
Zip	:	94710
Country	:	US
Telephone Number	:	510-981-4243
Fax Number	:	510-553-2169

Provider Business Practice Location Address
First Line	:	2031 6TH ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94710-2006
Country	:	US
Telephone Number	:	510-981-4243
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	03/08/2013

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