Provider Demographics
NPI:1598820482
Name:HALL, REBECCA ANNE (PT)
Entity Type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:ANNE
Last Name:HALL
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:550 S VERMONT AVE
Mailing Address - Street 2:7TH FLOOR, ROOM 704
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1912
Mailing Address - Country:US
Mailing Address - Phone:231-739-4376
Mailing Address - Fax:213-487-9658
Practice Address - Street 1:550 S VERMONT AVE
Practice Address - Street 2:7TH FLOOR, ROOM 704
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1912
Practice Address - Country:US
Practice Address - Phone:231-739-4376
Practice Address - Fax:213-487-9658
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30235167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician