MEDICARE: RACHEL FARRELL PA

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	176B00000X	Midwife	169	CA
2	363A00000X	Physician Assistant	PA12277	CA

General Provider Information

NPI Number	:	1699834770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL FARRELL PA

Provider Business Mailing Address
First Line	:	1908 N BEALE RD
Second Line	:	SUITE E
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-6937
Country	:	US
Telephone Number	:	530-743-6888
Fax Number	:	530-743-9823

Provider Business Practice Location Address
First Line	:	1908 N BEALE RD
Second Line	:	SUITE E
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-6937
Country	:	US
Telephone Number	:	530-743-6888
Fax Number	:	530-743-9823

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

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	08/09/2017

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