MEDICARE: REBECCA A COELHO

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1982926705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA A COELHO

Provider Business Mailing Address
First Line	:	1829 SILVANA LN
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-3060
Country	:	US
Telephone Number	:	831-464-2961
Fax Number	:	831-464-8678

Provider Business Practice Location Address
First Line	:	1829 SILVANA LN
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-3060
Country	:	US
Telephone Number	:	831-464-2961
Fax Number	:	831-464-8678

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

Provider Enumeration Date	:	02/21/2010
Last Update Date	:	12/29/2011

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Directions to “ REBECCA A COELHO ” Practice Location

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