Rebecca A Rogers, MH COUNSELOR
Individual provider Active NPI Counselor · Upper Lake, CA
NPI 1730360975 · NPPES record last updated Sep 29, 2011
Key facts
- NPI
- 1730360975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 565 Clover Dr
Upper Lake, CA 95485-9233 - Phone
- (707) 275-9555
- Fax
- (707) 275-9555
- NPI assigned
- Nov 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMF06116104 | CA | MD | Pastoral Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes | ||
| Pastoral Counselor | 101YP1600X | AMF06116104 | CA |
Addresses
Primary practice location
565 Clover Dr
Upper Lake, CA 95485-9233
Mailing address
565 Clover Dr
Upper Lake, CA 95485-9233
Phone (707) 275-9555
Other names
- Rebecca A Manley
Other providers in Upper Lake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.