Provider Demographics
NPI:1255000907
Name:VELA, REBECCA (CADAC-1)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:VELA
Suffix:
Gender:F
Credentials:CADAC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4714
Mailing Address - Country:US
Mailing Address - Phone:209-662-4688
Mailing Address - Fax:
Practice Address - Street 1:1300 E 14TH ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4714
Practice Address - Country:US
Practice Address - Phone:510-666-9552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)