Healthcare Provider Details

I. General information

NPI: 1902095680
Provider Name (Legal Business Name): REBEKAH A. POPE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5340 SKYLANE BLVD
SANTA ROSA CA
95403-1082
US

IV. Provider business mailing address

5340 SKYLANE BLVD
SANTA ROSA CA
95403-8246
US

V. Phone/Fax

Practice location:
  • Phone: 707-595-0205
  • Fax:
Mailing address:
  • Phone: 773-443-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberLCSW65913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: