Healthcare Provider Details

I. General information

NPI: 1972519650
Provider Name (Legal Business Name): REBECCA ANNE GEHLKE NOLAN PSYD, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS REBECCA ANNE GEHLKE-BAEZ

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7755 CENTER AVE STE 1100
HUNTINGTON BEACH CA
92647-3091
US

IV. Provider business mailing address

7755 CENTER AVE STE 1100
HUNTINGTON BEACH CA
92647-3091
US

V. Phone/Fax

Practice location:
  • Phone: 949-734-0746
  • Fax:
Mailing address:
  • Phone: 949-734-0746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC39064
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: