Provider Demographics
NPI:1225763543
Name:VEENKAMP, RACHEL ANN
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:VEENKAMP
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 1:1120 W LA VETA AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4243
Mailing Address - Country:US
Mailing Address - Phone:714-900-3413
Mailing Address - Fax:
Practice Address - Street 1:1120 W LA VETA AVE STE 400
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4243
Practice Address - Country:US
Practice Address - Phone:714-509-8259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2024-10-10
Deactivation Date:2024-08-06
Deactivation Code:
Reactivation Date:2024-10-09
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program