Healthcare Provider Details

I. General information

NPI: 1003772005
Provider Name (Legal Business Name): REBEKA KATHERYN FAIRCHILD I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 JOSEPHINE AVE
MADERA CA
93636-6523
US

IV. Provider business mailing address

598 JOSEPHINE AVE
MADERA CA
93636-6523
US

V. Phone/Fax

Practice location:
  • Phone: 559-373-3125
  • Fax:
Mailing address:
  • Phone: 559-373-3125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: