Healthcare Provider Details

I. General information

NPI: 1144642182
Provider Name (Legal Business Name): REBEKAH CAHOON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6529 CROWN BLVD STE D
SAN JOSE CA
95120-2905
US

IV. Provider business mailing address

PO BOX 3044
SARATOGA CA
95070-1044
US

V. Phone/Fax

Practice location:
  • Phone: 408-975-2957
  • Fax:
Mailing address:
  • Phone: 408-666-3015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number78352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: