Provider Demographics
NPI:1902185937
Name:LERNER, REBEKKA DANELLE (MS, MFTI)
Entity Type:Individual
Prefix:
First Name:REBEKKA
Middle Name:DANELLE
Last Name:LERNER
Suffix:
Gender:F
Credentials:MS, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6857 TULANE AVE
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-1324
Mailing Address - Country:US
Mailing Address - Phone:805-795-8244
Mailing Address - Fax:
Practice Address - Street 1:38 TELOMA DR
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2155
Practice Address - Country:US
Practice Address - Phone:805-807-9167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58107106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist