Rebecca Pearl Anne Church, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61647210 Issued in WA

Practice address

411 S 12TH Ave
Yakima, WA 98902-3109

Phone

(509) 823-8190

NPI assigned

Feb 11, 2025

Sex

Female

Sole proprietor

Yes

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

Practice roles

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.

• Sundown M Ranch

  • Substance Abuse Rehabilitation Facility
  • Yakima, WA
  • NPI 1154474104
  NPD (past)

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1952116345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 S 67TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989039478",
            "telephone_number": "509-823-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S 12TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023109",
            "telephone_number": "509-823-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "REBECCA",
        "middle_name": "PEARL ANNE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61647210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linh Chu
• Chester Sim Chua, MD
• Melissa M Chung
• Mitchell Chung
• Richard Chung
• Anne Eve Ciccarelli, MD
• Cicero Counseling and Forensic Evaluation LLC
• Julie K Cicero, LICSW
• Felipe Ivan Ciriano
• Angelica Cisneros, MA

• Psychiatric/Mental Health Nurse Practitioner in Yakima, WA
• Providers in Yakima, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.