Healthcare Provider Details

I. General information

NPI: 1730017427
Provider Name (Legal Business Name): REBECCA KAYE GARRETT PEER SUPPORT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 MAIN STREET
CHESTER CA
96020
US

IV. Provider business mailing address

PO BOX 354
CHESTER CA
96020-0354
US

V. Phone/Fax

Practice location:
  • Phone: 530-297-8140
  • Fax: 530-283-6045
Mailing address:
  • Phone: 530-816-9294
  • Fax: 530-283-6045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-BPLIUM
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: