Healthcare Provider Details

I. General information

NPI: 1255246096
Provider Name (Legal Business Name): REBECCA ANN ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 VICTOR AVE STE D
REDDING CA
96003-4859
US

IV. Provider business mailing address

10334 HAPPY HOLLOW LN
PALO CEDRO CA
96073-9502
US

V. Phone/Fax

Practice location:
  • Phone: 530-941-8028
  • Fax:
Mailing address:
  • Phone: 530-941-8028
  • Fax: 530-941-8028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberLEP3977
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLEP3977
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: