Provider Demographics
NPI:1952639536
Name:ALLAN, REBECCA SUE (SPEECH PATHOLOGY)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:SUE
Last Name:ALLAN
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1370 BREA BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4125
Mailing Address - Country:US
Mailing Address - Phone:714-394-9150
Mailing Address - Fax:714-671-7820
Practice Address - Street 1:1370 BREA BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4125
Practice Address - Country:US
Practice Address - Phone:714-394-9150
Practice Address - Fax:714-671-7820
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CASP9444235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist