Healthcare Provider Details

I. General information

NPI: 1801993597
Provider Name (Legal Business Name): REBECA HERRERA R.R.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST
SAN FRANCISCO CA
94121-1545
US

IV. Provider business mailing address

2201 BRIDGEPOINTE PKWY APT 313
SAN MATEO CA
94404-5010
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax:
Mailing address:
  • Phone: 650-242-8733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number62886
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: