Provider Demographics
NPI:1093198848
Name:REHFELD, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:REHFELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-5433
Mailing Address - Country:US
Mailing Address - Phone:626-335-1919
Mailing Address - Fax:626-335-1919
Practice Address - Street 1:1620 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-5433
Practice Address - Country:US
Practice Address - Phone:626-335-1919
Practice Address - Fax:626-335-1911
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA495219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily