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NPI Code Detail

MEDICARE: MRS. WENDY REBENTISCH MS, LPHA WAIVED

MEDICARE: MRS. WENDY REBENTISCH MS, LPHA WAIVED
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
11041C0700XClinical Social WorkerASW28774CA

General Provider Information

NPI Number : 1154443323
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. WENDY REBENTISCH MS, LPHA WAIVED
Provider Business Mailing Address
First Line : 3555 AUBURN BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-2005
Country : US
Telephone Number : 916-482-2370
Fax Number : 916-480-6241
Provider Business Practice Location Address
First Line : 3555 AUBURN BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-2005
Country : US
Telephone Number : 916-482-2370
Fax Number : 916-480-6241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 01/21/2011

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