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General NPI Number Information
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NPI Number | 1841746237
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Entity Type | Individual
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Provider Name | REBECCA M. PICARD M.A.
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Gender | Female
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Dates
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Enumeration Date | 08/26/2016
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 45121 UKIAH STREET SUITE C
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City | MENDOCINO
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State | CA
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Zip | 95460
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Country | US
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Telephone | 707-357-8688
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Fax | 707-962-9237
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Provider Business Mailing Address
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Address Line | PO BOX 832
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City | MENDOCINO
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State | CA
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Zip | 95460-0832
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Country | US
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Telephone | 707-357-8688
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Fax | 707-962-9237
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF93080
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 112212
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License Number State | CA
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