Physician Compare National (NPI:1659562791)

HEALTHCARE PROVIDER: REBECCA PORTEOUS LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1659562791
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991968653
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120517000251
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PORTEOUS
	Individual professional last name
Provider First Name	REBECCA
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3135 BOEING AVE
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	MCKINLEYVILLE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	955199373
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7074995203
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y