Healthcare Provider Details

I. General information

NPI: 1902694094
Provider Name (Legal Business Name): REBECCA KENT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 SAN PABLO AVE
EL CERRITO CA
94530-2194
US

IV. Provider business mailing address

2433 ACTON ST
BERKELEY CA
94702-2109
US

V. Phone/Fax

Practice location:
  • Phone: 415-456-7724
  • Fax:
Mailing address:
  • Phone: 510-847-1264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT164892
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: