Individual provider Active NPI

Rebekah Cossette Smith, BA

  • Student in an Organized Health Care Education/Training Program
  • Sylmar, CA
National Provider Identifier
1134807654
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
14445 Olive View Dr RM 2B182
Sylmar, CA 91342-1438
Phone
(747) 210-3205
NPI assigned
Jul 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

14445 Olive View Dr RM 2B182
Sylmar, CA 91342-1438

Mailing address

14445 Olive View Dr RM 2B182
Sylmar, CA 91342-1438

Other practice location 1

4610 X St Ste 1202
Sacramento, CA 95817-2200
Phone (916) 734-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260624001669 PA Order and Referring Only - OphthalmologyPractitioner - Ophthalmology 2860965514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1134807654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR RM 2B182",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR RM 2B182",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421438",
            "telephone_number": "747-210-3205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4610 X St Ste 1202",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172200",
            "country_code": "US",
            "telephone_number": "916-734-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "REBEKAH",
        "middle_name": "COSSETTE",
        "name_prefix": "Ms.",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.