Provider Demographics
NPI:1811615677
Name:ADELPOUR, RACHEL (FNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:ADELPOUR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10565 CIVIC CENTER DR STE 250
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3854
Mailing Address - Country:US
Mailing Address - Phone:909-493-3800
Mailing Address - Fax:
Practice Address - Street 1:2650 JONES WAY STE 9
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1218
Practice Address - Country:US
Practice Address - Phone:805-915-4440
Practice Address - Fax:805-915-4327
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95021584363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner