Provider Demographics
NPI:1124177993
Name:CARPENTER, RACHEL ANN
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:HUGHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44449 PENBROOK LN
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5625
Mailing Address - Country:US
Mailing Address - Phone:636-293-1438
Mailing Address - Fax:
Practice Address - Street 1:3020 CHILDRENS WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4223
Practice Address - Country:US
Practice Address - Phone:760-591-0179
Practice Address - Fax:760-501-0349
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 281152251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics