Rebecca Jean Anderson, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

AT5541 Issued in CA

Practice address

81 Professional Pkwy
San Rafael, CA 94903-2702

Phone

(415) 479-5161

NPI assigned

Mar 23, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1396448080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 CHANNING WAY APT 261",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032601",
            "telephone_number": "415-299-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 PROFESSIONAL PKWY",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032702",
            "telephone_number": "415-479-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "REBECCA",
        "middle_name": "JEAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "AT5541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amrita Family Therapy
• Kayla Andersen
• Kristin Andersen
• Derik Anderson, DC
• Joseph Michael Anderson, M.D.
• Jenniffer Gielyn Andes
• Erin Odysseus Andrianos, BS
• Julane Andries, LMFT
• Joseph Andris, DO
• Suha Anees

• Physical Medicine & Rehabilitation Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.