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MRS. RACHELLE VANDER DUSSEN RN

>> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1699973768

Individual Registrant:
MRS. RACHELLE  VANDER DUSSEN RN
Gender: F
Sole Proprietor

Location and contact information for practice:
19467 SEXTON RD  ESCALON, CA 95320 US
Tel: 209-402-8038  Fax: --

Contact information for business:
19467 SEXTON RD  ESCALON, CA 95320-9711 US
Tel: --  Fax: --

Registration Information:
NPI: 1699973768
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y163W00000XNursing Service Providers
Registered Nurse
CA625600

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDI-CAL PROVIDER NUMBERRVN001740CA01
MEDI-CAL PROVIDER NUMBEREPS012310CA01




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