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General NPI Number Information
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NPI Number | 1447133095
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Entity Type | Individual
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Provider Name | KARY REKSTAD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 35912 AVENUE H
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City | YUCAIPA
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State | CA
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Zip | 92399-5206
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Country | US
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Telephone | 909-790-8550
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 HOLMES WAY
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City | CALIMESA
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State | CA
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Zip | 92320-1442
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Country | US
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Telephone | 619-751-2332
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 240214060
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License Number State | CA
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