Doctor Name: | DR. RACHEL MICHELLE EGELINE |
NPI Number: | 1104197177 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | PSY22745 |
Business Practice Address: | 900 Quebec Ave Corcoran, CA - 93212 |
Business Phone Number: | 5599927100 |
Business Fax Number: | |
Mailing Address: | 2736 Keats Ave, CLOVIS |
State: | CA |
Postal Code: | 936116965 |
Phone Number: | 5592999249 |
Fax Number: | |
NPI Enumeration Date: | 01/23/2012 |
NPI Last Update Date: | 01/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY22745 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |