Provider Demographics
NPI:1871963835
Name:WU, RACHEL (NP-C, PA-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:NP-C, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10332 S STELLING RD
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-4227
Mailing Address - Country:US
Mailing Address - Phone:408-892-9488
Mailing Address - Fax:
Practice Address - Street 1:1375 BLOSSOM HILL RD
Practice Address - Street 2:STE. 49
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-3806
Practice Address - Country:US
Practice Address - Phone:408-440-8335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-03
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52910363A00000X
CA95003312363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant