Healthcare Provider Details

I. General information

NPI: 1467357632
Provider Name (Legal Business Name): REBECCA CLARISE LAVAUGHN FROST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2307 W 6TH ST
LOS ANGELES CA
90057-3119
US

IV. Provider business mailing address

3956 DALTON AVE
LOS ANGELES CA
90062-1212
US

V. Phone/Fax

Practice location:
  • Phone: 213-351-2800
  • Fax:
Mailing address:
  • Phone: 650-485-0156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: