=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255246096
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA ANN ANDERSON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2026
-----------------------------------------------------
Last Update Date | 08/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1405 VICTOR AVE STE D
-----------------------------------------------------
City | REDDING
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96003-4859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-941-8028
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10334 HAPPY HOLLOW LN
-----------------------------------------------------
City | PALO CEDRO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96073-9502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-941-8028
-----------------------------------------------------
Fax | 530-941-8028
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YS0200X
-----------------------------------------------------
Taxonomy Name | School Counselor
-----------------------------------------------------
License Number | LEP3977
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | LEP3977
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------