Provider Demographics
NPI:1659582047
Name:KILPATRICK, REBECCA B (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:B
Last Name:KILPATRICK
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:B
Other - Last Name:KILPARTRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:1962 WILCOX CIR
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-1947
Mailing Address - Country:US
Mailing Address - Phone:714-524-6442
Mailing Address - Fax:
Practice Address - Street 1:725 W LA VETA AVE STE 220
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4446
Practice Address - Country:US
Practice Address - Phone:714-639-3134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306401363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics