Provider Demographics
NPI:1073866307
Name:QUENTMEYER, REBECCA MARIE SOMERVELL (SLP CCC-MA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE SOMERVELL
Last Name:QUENTMEYER
Suffix:
Gender:F
Credentials:SLP CCC-MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22810 TREE FARM RD
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95713-9713
Mailing Address - Country:US
Mailing Address - Phone:530-846-8074
Mailing Address - Fax:
Practice Address - Street 1:22810 TREE FARM RD
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:CA
Practice Address - Zip Code:95713-9713
Practice Address - Country:US
Practice Address - Phone:530-846-8074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 15834235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist