Provider Demographics
NPI:1013547421
Name:GOLDEN, REBECCA (MA, AMFT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:RAE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:147 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-3152
Mailing Address - Country:US
Mailing Address - Phone:562-480-8078
Mailing Address - Fax:
Practice Address - Street 1:12631 IMPERIAL HWY STE C103
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-6735
Practice Address - Country:US
Practice Address - Phone:562-406-7385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist