Provider Demographics
NPI:1093843427
Name:SCRAFFORD, REBECCA JANE HERREMAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JANE HERREMAN
Last Name:SCRAFFORD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2542 NE COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7685
Mailing Address - Country:US
Mailing Address - Phone:541-706-7730
Mailing Address - Fax:541-706-4760
Practice Address - Street 1:2600 NE NEFF RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6337
Practice Address - Country:US
Practice Address - Phone:541-706-6843
Practice Address - Fax:541-598-3444
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1930103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical