MEDICARE: RACHEL EVERLENA POWELL

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	103TS0200X	School Psychologist	250241594	CA

General Provider Information

NPI Number	:	1649145251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL EVERLENA POWELL

Provider Business Mailing Address
First Line	:	4210 TECHNOLOGY DR
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-6337
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5200 VALPEY PARK AVE
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-3262
Country	:	US
Telephone Number	:	510-657-0322
Fax Number	:

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

Provider Enumeration Date	:	10/06/2025
Last Update Date	:	10/06/2025

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