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NPI Code Detail

MEDICARE: DR. REBECCA MATHEW

MEDICARE: DR. REBECCA MATHEW
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
1103TC0700XClinical PsychologistRPS-2012374CA
2101Y00000XCounselor

General Provider Information

NPI Number : 1801174669
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REBECCA MATHEW
Provider Business Mailing Address
First Line : 250 EXECUTIVE PARK BLVD STE 4900
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94134-3335
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 250 EXECUTIVE PARK BLVD STE 4900
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94134-3335
Country : US
Telephone Number : 415-656-0116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2011
Last Update Date : 03/17/2018

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