Provider Demographics
NPI:1700013877
Name:NEELEY, REBECCA RUTH (LMFT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:RUTH
Last Name:NEELEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31424 ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-6240
Mailing Address - Country:US
Mailing Address - Phone:909-936-5980
Mailing Address - Fax:909-660-0410
Practice Address - Street 1:31424 ORCHARD LN
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6240
Practice Address - Country:US
Practice Address - Phone:909-936-5980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46598106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist