MEDICARE: REBECCA CARREON DNP, FNP, PMHNP-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	363LF0000X	Family Nurse Practitioner	547032	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP108761	TX

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	:	1811004898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA CARREON DNP, FNP, PMHNP-C

Provider Business Mailing Address
First Line	:	6800 PARK TEN BLVD STE 200S
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-4293
Country	:	US
Telephone Number	:	210-261-1000
Fax Number	:	210-261-1821

Provider Business Practice Location Address
First Line	:	1920 BURNET ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78202-2517
Country	:	US
Telephone Number	:	210-261-1250
Fax Number	:	210-227-7059

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	04/10/2023

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