Healthcare Provider Details

I. General information

NPI: 1740101310
Provider Name (Legal Business Name): REBECCA BARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10089 WILLOW CREEK RD STE 200
SAN DIEGO CA
92131-1699
US

IV. Provider business mailing address

1005 RIBBON LN
CHARLOTTE NC
28205-5417
US

V. Phone/Fax

Practice location:
  • Phone: 800-683-1209
  • Fax:
Mailing address:
  • Phone: 336-776-8158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: