Provider Demographics
NPI:1477787216
Name:GORBAN, REBECCA (MSW ANTICIPATED 5/27)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GORBAN
Suffix:
Gender:F
Credentials:MSW ANTICIPATED 5/27
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5026 MAYTIME LN
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-5056
Mailing Address - Country:US
Mailing Address - Phone:310-804-1257
Mailing Address - Fax:
Practice Address - Street 1:5026 MAYTIME LN
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-5056
Practice Address - Country:US
Practice Address - Phone:310-804-1257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical