Provider Demographics
NPI:1124425012
Name:NEMTZOV, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:NEMTZOV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-8812
Mailing Address - Country:US
Mailing Address - Phone:805-488-3578
Mailing Address - Fax:
Practice Address - Street 1:400 CAMARILLO RANCH ROAD
Practice Address - Street 2:SUITE 209
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5903
Practice Address - Country:US
Practice Address - Phone:805-242-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16479235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist