Healthcare Provider Details

I. General information

NPI: 1801243720
Provider Name (Legal Business Name): REBEKAH ANN VANDERZEE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9718 HARVARD ST
BELLFLOWER CA
90706-3635
US

IV. Provider business mailing address

16221 OREGON AVE
BELLFLOWER CA
90706-5068
US

V. Phone/Fax

Practice location:
  • Phone: 562-925-2777
  • Fax: 562-925-7572
Mailing address:
  • Phone: 909-717-2909
  • Fax: 562-679-4618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28390
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: