Provider Demographics
NPI:1538382213
Name:REYES, RACHEL C (MSPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:C
Last Name:REYES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:C
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:69472 SERENITY RD
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-7921
Mailing Address - Country:US
Mailing Address - Phone:760-409-6383
Mailing Address - Fax:855-586-6292
Practice Address - Street 1:69472 SERENITY RD
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7921
Practice Address - Country:US
Practice Address - Phone:702-386-7980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2114225100000X
CA32684225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist