Healthcare Provider Details

I. General information

NPI: 1063028405
Provider Name (Legal Business Name): REBECCA ANN BECKETT RN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 W FOOTHILL BLVD STE 200
CLAREMONT CA
91711-3475
US

IV. Provider business mailing address

675 W FOOTHILL BLVD STE 200
CLAREMONT CA
91711-3475
US

V. Phone/Fax

Practice location:
  • Phone: 925-282-1778
  • Fax: 480-546-3134
Mailing address:
  • Phone: 925-282-1778
  • Fax: 480-546-3134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95019301
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: