Healthcare Provider Details

I. General information

NPI: 1932025293
Provider Name (Legal Business Name): REBECCA LAUREN MALTEZ CSA, CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA CABALLERO

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 23RD ST
NEWPORT NEWS VA
23607-4703
US

IV. Provider business mailing address

1029 23RD ST
NEWPORT NEWS VA
23607-4703
US

V. Phone/Fax

Practice location:
  • Phone: 956-202-9094
  • Fax:
Mailing address:
  • Phone: 956-202-9094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: