Healthcare Provider Details

I. General information

NPI: 1356571624
Provider Name (Legal Business Name): REBECCA ARCOS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

597 CENTER AVE STE 150
MARTINEZ CA
94553-4674
US

IV. Provider business mailing address

2500 ALHAMBRA AVE
MARTINEZ CA
94553-3156
US

V. Phone/Fax

Practice location:
  • Phone: 925-313-6250
  • Fax:
Mailing address:
  • Phone: 925-370-5110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number742853
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20548
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: