Provider Demographics
NPI:1225319759
Name:ROUSE, REBECCA (PSYD)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:ROUSE
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 1:727 2ND ST UNIT 105
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-5245
Mailing Address - Country:US
Mailing Address - Phone:310-874-9411
Mailing Address - Fax:
Practice Address - Street 1:727 2ND ST UNIT 105
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-5245
Practice Address - Country:US
Practice Address - Phone:424-438-0738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor