MEDICARE: REBEKAH LYNN NUPP LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	75902	CA

General Provider Information

NPI Number	:	1043520729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH LYNN NUPP LCSW

Provider Business Mailing Address
First Line	:	2444 S ALAMEDA ST
Second Line	:
City	:	VERNON
State	:	CA
Zip	:	90058-1334
Country	:	US
Telephone Number	:	916-516-4989
Fax Number	:

Provider Business Practice Location Address
First Line	:	2444 S ALAMEDA ST
Second Line	:
City	:	VERNON
State	:	CA
Zip	:	90058-1334
Country	:	US
Telephone Number	:	916-516-4989
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2010
Last Update Date	:	06/23/2025

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