Provider Demographics
NPI:1467547828
Name:KAHANE, REBECCA GERBER (MFT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:GERBER
Last Name:KAHANE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-3730
Mailing Address - Country:US
Mailing Address - Phone:310-925-0607
Mailing Address - Fax:
Practice Address - Street 1:333 RICHMOND ST
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-3730
Practice Address - Country:US
Practice Address - Phone:310-925-0607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37382106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist