Healthcare Provider Details

I. General information

NPI: 1598175762
Provider Name (Legal Business Name): REBECCA HADEED DO, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA RENEE ROACH DO, MPH

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N FRESNO ST
FRESNO CA
93701-2302
US

IV. Provider business mailing address

155 N FRESNO ST
FRESNO CA
93701-2302
US

V. Phone/Fax

Practice location:
  • Phone: 559-459-4300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0062827
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: