Provider Demographics
NPI:1093145229
Name:KNEBEL, REBECCA THERESE (DPT)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:THERESE
Last Name:KNEBEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 7TH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4687
Mailing Address - Country:US
Mailing Address - Phone:213-234-8348
Mailing Address - Fax:
Practice Address - Street 1:299 7TH AVE APT 1
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4687
Practice Address - Country:US
Practice Address - Phone:213-234-8348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33940225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist