Active NPI
Rachel Marie Doherty, RDH, RDHAP, MPH
- Dental Hygienist
- Fresno, CA
National Provider Identifier
1376307249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 532
- Practice address
- 4615 N Marty Ave
Fresno, CA 93722-4186 - Phone
- (559) 209-1894
- Fax
- (559) 270-4360
- NPI assigned
- Feb 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 532 | CA | Primary |
| Dental Hygienist | 124Q00000X | 23414 | CA |
Addresses
Primary practice location
4615 N Marty Ave
Fresno, CA 93722-4186
Mailing address
1489 E Magill Ave
Fresno, CA 93710-4206
Phone (559) 209-1894
Other names 1
- Rachel Marie Johnson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 532 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1376307249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1489 E MAGILL AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937104206",
"telephone_number": "559-209-1894",
"fax_number": "559-276-4360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4615 N MARTY AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937224186",
"telephone_number": "559-209-1894",
"fax_number": "559-270-4360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOHERTY",
"first_name": "RACHEL",
"middle_name": "MARIE",
"credential": "RDH, RDHAP, MPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-09",
"last_updated": "2024-02-09",
"certification_date": "2024-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "532",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "23414",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RACHEL",
"last_name": "JOHNSON",
"middle_name": "MARIE",
"credential": "CNA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.