Provider Demographics
NPI:1083075592
Name:GEALTA, REBECCA THERESE (CADC II, MA)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:THERESE
Last Name:GEALTA
Suffix:
Gender:F
Credentials:CADC II, MA
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:THERESE
Other - Last Name:RAABE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC II, MA
Mailing Address - Street 1:1922 THE ALAMEDA STE 316
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1461
Mailing Address - Country:US
Mailing Address - Phone:408-261-7777
Mailing Address - Fax:
Practice Address - Street 1:2001 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1136
Practice Address - Country:US
Practice Address - Phone:408-510-6284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)