Healthcare Provider Details

I. General information

NPI: 1346050408
Provider Name (Legal Business Name): REBECCA ANNE PAULSON APRN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6110 PLUMAS ST
RENO NV
89519-6076
US

IV. Provider business mailing address

316 CALIFORNIA AVE # 90
RENO NV
89509-1650
US

V. Phone/Fax

Practice location:
  • Phone: 775-786-6880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number863264
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95352061
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number863264
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: