Provider Demographics
NPI:1285860734
Name:GATHJE, REBECCA A (PHD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:GATHJE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:A
Other - Last Name:SHEFFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:985450 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-5450
Mailing Address - Country:US
Mailing Address - Phone:402-559-8943
Mailing Address - Fax:402-559-5737
Practice Address - Street 1:985450 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-5450
Practice Address - Country:US
Practice Address - Phone:402-559-8943
Practice Address - Fax:402-559-5737
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE755103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025287200Medicaid