Provider Demographics
NPI:1609892306
Name:PISTILLI, REBECCA COLLEEN (MFT)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:COLLEEN
Last Name:PISTILLI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BRISTOL ST N
Mailing Address - Street 2:SUITE 245B
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2911
Mailing Address - Country:US
Mailing Address - Phone:949-891-1195
Mailing Address - Fax:
Practice Address - Street 1:505 N EUCLID ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5506
Practice Address - Country:US
Practice Address - Phone:714-450-4225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor