Provider Demographics
NPI:1881583086
Name:KIMMEL, RACHEL AIMEE (RDN)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:AIMEE
Last Name:KIMMEL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10626 HOLMAN AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5955
Mailing Address - Country:US
Mailing Address - Phone:310-531-4854
Mailing Address - Fax:
Practice Address - Street 1:10626 HOLMAN AVE APT 3A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5955
Practice Address - Country:US
Practice Address - Phone:310-531-4854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86084391133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered