Provider Demographics
NPI:1073881975
Name:CORDERO, REBECCA LYNN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNN
Last Name:CORDERO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:KASPARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1690 WOODSIDE ROAD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061
Mailing Address - Country:US
Mailing Address - Phone:650-365-5093
Mailing Address - Fax:650-365-5093
Practice Address - Street 1:1690 WOODSIDE ROAD
Practice Address - Street 2:SUITE 112
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061
Practice Address - Country:US
Practice Address - Phone:650-365-5093
Practice Address - Fax:650-365-5093
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38639106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist