Healthcare Provider Details

I. General information

NPI: 1538082995
Provider Name (Legal Business Name): REBECCA VAUGHAN BDS MSC PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA MOAZZEZ BDS MSC PHD

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 5TH ST
SAN FRANCISCO CA
94103-2919
US

IV. Provider business mailing address

155 5TH ST
SAN FRANCISCO CA
94103-2919
US

V. Phone/Fax

Practice location:
  • Phone: 650-398-9586
  • Fax:
Mailing address:
  • Phone: 650-398-9867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number335
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: