Healthcare Provider Details

I. General information

NPI: 1457474181
Provider Name (Legal Business Name): REBECCA PATE RN, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6255 MISSION GORGE RD
SAN DIEGO CA
92120-3505
US

IV. Provider business mailing address

443 LOS ARBOLITOS BLVD
OCEANSIDE CA
92054-1529
US

V. Phone/Fax

Practice location:
  • Phone: 619-285-6416
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number531485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: