Healthcare Provider Details

I. General information

NPI: 1316533375
Provider Name (Legal Business Name): PATRICIA ANNE REBER HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2020
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3606 SIGNAL HILL TRL
COPPEROPOLIS CA
95228-9576
US

IV. Provider business mailing address

3606 SIGNAL HILL TRL
COPPEROPOLIS CA
95228-9576
US

V. Phone/Fax

Practice location:
  • Phone: 209-985-1710
  • Fax:
Mailing address:
  • Phone: 209-985-1710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberBL-0019010
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: