Provider Demographics
NPI:1043253321
Name:CARLSON, RACHEL (PA,C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:PA,C
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7555
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-7555
Mailing Address - Country:US
Mailing Address - Phone:530-898-8088
Mailing Address - Fax:530-898-8087
Practice Address - Street 1:6480 PENTZ RD
Practice Address - Street 2:SUITE B
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-3672
Practice Address - Country:US
Practice Address - Phone:530-877-9326
Practice Address - Fax:530-877-2196
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA16491363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP64062Medicare UPIN