Provider Demographics
NPI:1467500033
Name:COOK, REBECCA ANN (NPF)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:COOK
Suffix:
Gender:F
Credentials:NPF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 E STOWELL RD
Mailing Address - Street 2:STE C
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-7010
Mailing Address - Country:US
Mailing Address - Phone:805-934-5140
Mailing Address - Fax:805-934-3500
Practice Address - Street 1:915 E STOWELL RD
Practice Address - Street 2:STE C
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-7010
Practice Address - Country:US
Practice Address - Phone:805-934-5140
Practice Address - Fax:805-934-3500
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6232363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6232OtherNURSE PRACTITIONER