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NPI Code Detail

MEDICARE: MRS. REBECCA ANNE WEISS BA

MEDICARE: MRS. REBECCA ANNE WEISS BA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1629143664
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA ANNE WEISS BA
Provider Business Mailing Address
First Line : 1100 SPORTFISHER DR
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-2550
Country : US
Telephone Number : 760-439-6702
Fax Number : 760-439-4779
Provider Business Practice Location Address
First Line : 1100 SPORTFISHER DR
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-2550
Country : US
Telephone Number : 760-439-6702
Fax Number : 760-439-4779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2006
Last Update Date : 11/09/2007

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