Healthcare Provider Details

I. General information

NPI: 1003783762
Provider Name (Legal Business Name): RUKHSHANDA ABDUR REHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

DEPARTMENT OF APPLIED PSYCHOLOGY, LCWU
LAHORE PUNJAB
54590
PK

IV. Provider business mailing address

2781 EMILY WAY
LIVE OAK CA
95953-2826
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: