Provider Demographics
NPI:1326254467
Name:WOLF, REBECCA HELAINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:HELAINE
Last Name:WOLF
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 1:9171 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 680
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5530
Mailing Address - Country:US
Mailing Address - Phone:310-535-3833
Mailing Address - Fax:310-271-5459
Practice Address - Street 1:9171 WILSHIRE BLVD
Practice Address - Street 2:SUITE 680
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5530
Practice Address - Country:US
Practice Address - Phone:310-535-3833
Practice Address - Fax:310-271-5459
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 36045106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist