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General NPI Number Information
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NPI Number | 1144902768
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Entity Type | Individual
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Provider Name | REBECCA GRAHAM PHD
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Gender | Female
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 2041 EAST ST STE 1241
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City | CONCORD
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State | CA
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Zip | 94520-2126
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Country | US
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Telephone | 858-771-0556
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Fax |
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Provider Business Mailing Address
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Address Line | 2041 EAST ST STE 1241
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City | CONCORD
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State | CA
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Zip | 94520-2126
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Country | US
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Telephone | 858-771-0556
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 009789
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 35785
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License Number State | CA
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