Provider Demographics
NPI:1437610995
Name:KOLKER ZHANG, REBECCA LEE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LEE
Last Name:KOLKER ZHANG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LEE
Other - Last Name:KOLKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:750 ALMA LANE SUITE 100 #4232
Mailing Address - Street 2:
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404
Mailing Address - Country:US
Mailing Address - Phone:650-667-0652
Mailing Address - Fax:
Practice Address - Street 1:1660 S AMPHLETT BLVD STE 217
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2508
Practice Address - Country:US
Practice Address - Phone:650-667-0652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100827106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist