Individual provider Active NPI

Rebecca Marie Rebstad-Peek, LVN

  • Licensed Vocational Nurse
  • Anaheim, CA
National Provider Identifier
1871861567
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN258561 Issued in CA
Practice address
10755 Magnolia Ave
Unit# 103
Anaheim, CA 92804-6262
Phone
(562) 394-7081
NPI assigned
Dec 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN258561 CA Primary

Addresses

Primary practice location

10755 Magnolia Ave
Unit# 103
Anaheim, CA 92804-6262

Mailing address

10755 Magnolia Ave
Unit# 103
Anaheim, CA 92804-6262
Phone (562) 394-7081

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
VN258561CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1871861567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10755 MAGNOLIA AVE",
            "address_2": "UNIT# 103",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928046262",
            "telephone_number": "562-394-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10755 MAGNOLIA AVE",
            "address_2": "UNIT# 103",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928046262",
            "telephone_number": "562-394-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBSTAD-PEEK",
        "first_name": "REBECCA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN258561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.