Provider Demographics
NPI:1821535212
Name:SHALEV, REBECCAH ILANA (ND)
Entity Type:Individual
Prefix:DR
First Name:REBECCAH
Middle Name:ILANA
Last Name:SHALEV
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 734
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-0734
Mailing Address - Country:US
Mailing Address - Phone:415-517-7423
Mailing Address - Fax:
Practice Address - Street 1:1065 E HILLSDALE BLVD STE 108
Practice Address - Street 2:
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-1688
Practice Address - Country:US
Practice Address - Phone:650-638-1141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60699891175F00000X
CA885175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath