1467692061 NPI number — REBECCA RENEE ANDERSON LMFT

Table of content: REBECCA RENEE ANDERSON LMFT (NPI 1467692061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467692061 NPI number — REBECCA RENEE ANDERSON LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERSON
Provider First Name:
REBECCA
Provider Middle Name:
RENEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467692061
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1922 THE ALAMEDA STE 316
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95126-1461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-261-7777
Provider Business Mailing Address Fax Number:
408-642-6052

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 THE ALAMEDA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95126-1136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-510-6284
Provider Business Practice Location Address Fax Number:
408-642-6052
Provider Enumeration Date:
02/23/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  48490 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)