Provider Demographics
NPI:1932813425
Name:WATTERS, RACHEL MORIAH (PA-C, MPH, MHA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MORIAH
Last Name:WATTERS
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Gender:F
Credentials:PA-C, MPH, MHA
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Mailing Address - Street 1:5060 SHOREHAM PL STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5904
Mailing Address - Country:US
Mailing Address - Phone:858-221-0344
Mailing Address - Fax:
Practice Address - Street 1:5060 SHOREHAM PL STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5904
Practice Address - Country:US
Practice Address - Phone:858-221-0344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA62309363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant