Provider Demographics
NPI:1578267472
Name:POPKE, REBECCA SUSANNE LUDEN
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUSANNE LUDEN
Last Name:POPKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:SUSANNE
Other - Last Name:LUDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:371 ALDER LN
Mailing Address - Street 2:
Mailing Address - City:BUELLTON
Mailing Address - State:CA
Mailing Address - Zip Code:93427-6800
Mailing Address - Country:US
Mailing Address - Phone:805-450-9353
Mailing Address - Fax:
Practice Address - Street 1:315 CAMINO DEL REMEDIO STE 258
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1332
Practice Address - Country:US
Practice Address - Phone:805-681-5220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT79576106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist