MEDICARE: REBEKAH EKBERG

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	106H00000X	Marriage & Family Therapist	91248	CA

General Provider Information

NPI Number	:	1477803880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH EKBERG

Provider Business Mailing Address
First Line	:	PO BOX 3901
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94703-0901
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 BROADWAY
Second Line	:	SUITE 732
City	:	OAKLAND
State	:	CA
Zip	:	94612-2503
Country	:	US
Telephone Number	:	510-698-2327
Fax Number	:

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

Provider Enumeration Date	:	09/12/2012
Last Update Date	:	03/25/2016

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Directions to “ REBEKAH EKBERG ” Practice Location

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