Individual provider Active NPI

Rebekah So

  • Clinical Psychologist
  • Claremont, CA
National Provider Identifier
1306299771
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY32456 Issued in CA
Practice address
101 N Indian Hill Blvd Ste C1-200
Claremont, CA 91711-4667
Phone
(909) 333-7434
NPI assigned
Jul 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY32456 CA Primary

Addresses

Primary practice location

101 N Indian Hill Blvd Ste C1-200
Claremont, CA 91711-4667

Mailing address

101 N Indian Hill Blvd Ste C1-200
Claremont, CA 91711-4667
Phone (909) 333-7434

Other practice location 1

311 Winston St
Los Angeles, CA 90013-1519
Phone (213) 893-1960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY32456CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arc Counseling and Wellness CurrentSince May 22, 2022 Accepting new patients

Locations

101 N Indian Hill Blvd
Ste C1-200
Claremont, CA 91711
Phone (866) 200-9090

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1306299771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N INDIAN HILL BLVD STE C1-200",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114667",
            "telephone_number": "909-333-7434",
            "fax_number": "909-503-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N INDIAN HILL BLVD STE C1-200",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114667",
            "telephone_number": "909-333-7434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 Winston St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900131519",
            "country_code": "US",
            "telephone_number": "213-893-1960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SO",
        "first_name": "REBEKAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.