Healthcare Provider Details

I. General information

NPI: 1124979901
Provider Name (Legal Business Name): REBEKAH ANNE WILSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 TUREAUD LN
CLOVIS CA
93619-7690
US

IV. Provider business mailing address

808 TUREAUD LN
CLOVIS CA
93619-7690
US

V. Phone/Fax

Practice location:
  • Phone: 559-632-5404
  • Fax:
Mailing address:
  • Phone: 559-632-5404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number161462
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: