Healthcare Provider Details

I. General information

NPI: 1417774506
Provider Name (Legal Business Name): REBEKAH DENNING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7250 MESA COLLEGE DR
SAN DIEGO CA
92111-4999
US

IV. Provider business mailing address

8685 CAMDEN DR
SANTEE CA
92071-3926
US

V. Phone/Fax

Practice location:
  • Phone: 619-388-2421
  • Fax:
Mailing address:
  • Phone: 559-789-4077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: