Provider Demographics
NPI:1467169391
Name:HINES, REBECCA (AMFT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HINES
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2577 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1159
Mailing Address - Country:US
Mailing Address - Phone:510-513-3706
Mailing Address - Fax:510-446-7108
Practice Address - Street 1:2577 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1159
Practice Address - Country:US
Practice Address - Phone:510-513-3706
Practice Address - Fax:510-446-7108
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health