Provider Demographics
NPI:1568760098
Name:HARRIS, REBECCA LOUISE (RRW)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LOUISE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RRW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9441 VALLEJO DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-3634
Mailing Address - Country:US
Mailing Address - Phone:916-519-2095
Mailing Address - Fax:
Practice Address - Street 1:406 SUNRISE AVE
Practice Address - Street 2:SUITE 310A
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4106
Practice Address - Country:US
Practice Address - Phone:916-782-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)