MEDICARE: MRS. REBEKAH A. POPE LCSW

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	1041S0200X	School Social Worker	LCSW65913	CA
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1902095680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBEKAH A. POPE LCSW

Provider Business Mailing Address
First Line	:	5340 SKYLANE BLVD
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-8246
Country	:	US
Telephone Number	:	773-443-9696
Fax Number	:

Provider Business Practice Location Address
First Line	:	5340 SKYLANE BLVD
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-1082
Country	:	US
Telephone Number	:	707-595-0205
Fax Number	:

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

Provider Enumeration Date	:	10/18/2007
Last Update Date	:	08/15/2025

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