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NPI Code Detail

MEDICARE: REBECCA ESTHER ABRAHAM MS SLP CFY

MEDICARE: REBECCA ESTHER ABRAHAM MS SLP CFY
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
1235Z00000XSpeech-Language Pathologist14505CA

General Provider Information

NPI Number : 1942798624
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ESTHER ABRAHAM MS SLP CFY
Provider Business Mailing Address
First Line : 1300 SOUTHAMPTON RD APT 195
Second Line :
City : BENICIA
State : CA
Zip : 94510-1745
Country : US
Telephone Number : 602-579-5355
Fax Number :
Provider Business Practice Location Address
First Line : 2200 TUOLUMNE ST
Second Line :
City : VALLEJO
State : CA
Zip : 94589-2523
Country : US
Telephone Number : 707-644-7401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2018
Last Update Date : 06/02/2020

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