Provider Demographics
NPI:1346711660
Name:RICKS, RACHEL ANN (HIS)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ANN
Last Name:RICKS
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2217
Mailing Address - Country:US
Mailing Address - Phone:530-200-0202
Mailing Address - Fax:
Practice Address - Street 1:3328 CHURN CREEK RD STE A
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2535
Practice Address - Country:US
Practice Address - Phone:530-221-7380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8211237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist