MEDICARE: DR. MELVIN JAY RABECK PH.D.

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	103TC0700X	Clinical Psychologist	PSY15058	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447283429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELVIN JAY RABECK PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 3718
Second Line	:
City	:	HALF MOON BAY
State	:	CA
Zip	:	94019-3718
Country	:	US
Telephone Number	:	650-713-5913
Fax Number	:	650-713-5915

Provider Business Practice Location Address
First Line	:	236 VALDEZ AVE
Second Line	:
City	:	HALF MOON BAY
State	:	CA
Zip	:	94019-1880
Country	:	US
Telephone Number	:	650-713-5913
Fax Number	:	650-713-5915

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	03/22/2023

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