Provider Demographics
NPI:1619277670
Name:NATION, REBECCA (MFT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NATION
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 1:555 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6521
Mailing Address - Country:US
Mailing Address - Phone:916-600-6469
Mailing Address - Fax:
Practice Address - Street 1:555 UNIVERSITY AVE
Practice Address - Street 2:STE 235
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6521
Practice Address - Country:US
Practice Address - Phone:916-600-6469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46149106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFT461490OtherBLUE SHIELD OF CALIFORNIA