Provider Demographics
NPI:1649531823
Name:KIENE, RACHEL R (LM, CPM)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:R
Last Name:KIENE
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10537 AMBASSADOR DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2401
Mailing Address - Country:US
Mailing Address - Phone:916-548-0672
Mailing Address - Fax:530-753-6142
Practice Address - Street 1:10537 AMBASSADOR DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-2401
Practice Address - Country:US
Practice Address - Phone:916-548-0672
Practice Address - Fax:530-753-6142
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM 0328176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife