Provider Demographics
NPI:1376876508
Name:WEINFELD, REBECCA (RN,C, LAC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:WEINFELD
Suffix:
Gender:F
Credentials:RN,C, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4245 CAPITOLA RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-3573
Mailing Address - Country:US
Mailing Address - Phone:831-662-3366
Mailing Address - Fax:
Practice Address - Street 1:4245 CAPITOLA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-3573
Practice Address - Country:US
Practice Address - Phone:831-662-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521363163WP0808X
CAAC7153171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health