MEDICARE: MRS. REBECCA M DEAN CNS

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	364SP0813X	Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist	397499	CA

General Provider Information

NPI Number	:	1669504999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA M DEAN CNS

Provider Business Mailing Address
First Line	:	6320 RIO BONITO DR
Second Line	:
City	:	CARMICHAEL
State	:	CA
Zip	:	95608-5215
Country	:	US
Telephone Number	:	916-716-2874
Fax Number	:

Provider Business Practice Location Address
First Line	:	6320 RIO BONITO DR
Second Line	:
City	:	CARMICHAEL
State	:	CA
Zip	:	95608-5215
Country	:	US
Telephone Number	:	916-716-2874
Fax Number	:

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	03/19/2008

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