Healthcare Provider Details

I. General information

NPI: 1770870842
Provider Name (Legal Business Name): REBECCA AUGUSTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2011
Last Update Date: 10/19/2025
Certification Date: 10/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15740 TURNBERRY ST
MORENO VALLEY CA
92555-4903
US

IV. Provider business mailing address

1235 N CALIFORNIA AVE
BEAUMONT CA
92223-1447
US

V. Phone/Fax

Practice location:
  • Phone: 951-363-8449
  • Fax:
Mailing address:
  • Phone: 714-883-9938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number154601
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: