Individual provider Active NPI

Rachel Detienne, PA-C

  • Medical Physician Assistant
  • Redlands, CA
National Provider Identifier
1649985615
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1801 Orange Tree LN Ste 100
Redlands, CA 92374-4588
Phone
(909) 674-1199
NPI assigned
Jan 13, 2023
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

1801 Orange Tree LN Ste 100
Redlands, CA 92374-4588

Mailing address

39686 Corte Gata
Murrieta, CA 92562-4373
Phone (951) 505-3819

Other practice location 1

27722 Clinton Keith Rd
Murrieta, CA 92562-8560
Phone (951) 878-9820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230602000545 CA Practitioner - Physician Assistant 4587021761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Symbiosis IncGroup PAC ID 7719310465, 6 clinicians

Practice addresses (Care Compare)

1801 Orange Tree LN
Suite 100
Redlands, CA 92374-4588
Phone (909) 880-2979

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
86.89
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1649985615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39686 CORTE GATA",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624373",
            "telephone_number": "951-505-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 ORANGE TREE LN STE 100",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744588",
            "telephone_number": "909-674-1199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27722 Clinton Keith Rd",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925628560",
            "country_code": "US",
            "telephone_number": "951-878-9820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DETIENNE",
        "first_name": "RACHEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-13",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.