MEDICARE: MS. REBECCA H KETNER C.A.T.C.

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	1693-I	CA

General Provider Information

NPI Number	:	1588822837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA H KETNER C.A.T.C.

Provider Business Mailing Address
First Line	:	1911 WILLIAMS DR
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93036-2612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1911 WILLIAMS DR
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93036-2612
Country	:	US
Telephone Number	:	805-981-9200
Fax Number	:

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

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	04/19/2026

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