MEDICARE: MS. REBECCA KOSKI MA, LMFT #88826

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	106H00000X	Marriage & Family Therapist	88826	CA

General Provider Information

NPI Number	:	1982963997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA KOSKI MA, LMFT #88826

Provider Business Mailing Address
First Line	:	1626 MONTANA AVE # 179
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-1808
Country	:	US
Telephone Number	:	310-985-4443
Fax Number	:	909-595-1329

Provider Business Practice Location Address
First Line	:	1626 MONTANA AVE # 179
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-1808
Country	:	US
Telephone Number	:	310-985-4443
Fax Number	:	909-595-1329

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

Provider Enumeration Date	:	05/10/2012
Last Update Date	:	02/05/2025

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