Provider Demographics
NPI:1831487602
Name:BAUKNIGHT, REBECCA S (PHD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:BAUKNIGHT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:SUE
Other - Last Name:BAUKNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1902 WEBSTER ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-5800
Mailing Address - Country:US
Mailing Address - Phone:415-929-2502
Mailing Address - Fax:415-929-2502
Practice Address - Street 1:1902 WEBSTER ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-5800
Practice Address - Country:US
Practice Address - Phone:415-929-2502
Practice Address - Fax:415-929-2502
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16271103T00000X, 103TC0700X
103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis