Provider Demographics
NPI:1477884948
Name:EVERT, REBECCA RUTH
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:RUTH
Last Name:EVERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 ANNED DR
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-5635
Mailing Address - Country:US
Mailing Address - Phone:714-732-8357
Mailing Address - Fax:
Practice Address - Street 1:2990 INLAND EMPIRE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4899
Practice Address - Country:US
Practice Address - Phone:909-980-3427
Practice Address - Fax:909-945-3426
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-23
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner