Provider Demographics
NPI:1326715558
Name:HOLLINGSWORTH, REBECCA (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:
Other - Last Name:LYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11201 BENTON STREET
Mailing Address - Street 2:122/VALOR BUILDING 32 - HOLLINGSWORTH
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92357
Mailing Address - Country:US
Mailing Address - Phone:909-478-4529
Mailing Address - Fax:909-777-3884
Practice Address - Street 1:11201 BENTON STREET
Practice Address - Street 2:122/VALOR BUILDING 32 - HOLLINGSWORTH
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92357
Practice Address - Country:US
Practice Address - Phone:909-478-4529
Practice Address - Fax:909-777-3884
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW769711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical