Healthcare Provider Details

I. General information

NPI: 1932874989
Provider Name (Legal Business Name): REBEKKA TERE DAGHER MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 BONAR ST
BERKELEY CA
94702-1793
US

IV. Provider business mailing address

81 VERNON ST APT 309
OAKLAND CA
94610-4205
US

V. Phone/Fax

Practice location:
  • Phone: 510-644-4500
  • Fax:
Mailing address:
  • Phone: 415-446-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number29379
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: