MEDICARE: REBECCA KAYE GARRETT PEER SUPPORT

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
1	175T00000X	Peer Specialist	MPSS-BPLIUM	CA

General Provider Information

NPI Number	:	1730017427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA KAYE GARRETT PEER SUPPORT

Provider Business Mailing Address
First Line	:	PO BOX 354
Second Line	:
City	:	CHESTER
State	:	CA
Zip	:	96020-0354
Country	:	US
Telephone Number	:	530-816-9294
Fax Number	:	530-283-6045

Provider Business Practice Location Address
First Line	:	372 MAIN STREET
Second Line	:
City	:	CHESTER
State	:	CA
Zip	:	96020
Country	:	US
Telephone Number	:	530-297-8140
Fax Number	:	530-283-6045

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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