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General NPI Number Information
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NPI Number | 1770251753
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Entity Type | Individual
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Provider Name | REBECCA A. WEITZEL LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 2109 MILLSAP PL
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City | WOODLAND
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State | CA
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Zip | 95776-5511
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Country | US
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Telephone | 916-300-0907
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 E COVELL BLVD STE B5
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City | DAVIS
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State | CA
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Zip | 95616-1366
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Country | US
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Telephone | 707-400-0981
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 27527
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License Number State | CA
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