Healthcare Provider Details

I. General information

NPI: 1487008694
Provider Name (Legal Business Name): REBEKAH FENTON MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2016
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14264 INNOVATION DR.
FOLSOM CA
95630
US

IV. Provider business mailing address

14264 INNOVATION DR.
FOLSOM CA
95630
US

V. Phone/Fax

Practice location:
  • Phone: 916-946-1700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA201746
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberA201746
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: