Provider Demographics
NPI:1972519650
Name:GEHLKE NOLAN, REBECCA ANNE (PSYD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANNE
Last Name:GEHLKE NOLAN
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:ANNE
Other - Last Name:GEHLKE-BAEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5942 EDINGER AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-1773
Mailing Address - Country:US
Mailing Address - Phone:714-943-6922
Mailing Address - Fax:
Practice Address - Street 1:6512 OXFORD DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-2642
Practice Address - Country:US
Practice Address - Phone:714-943-6922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39064106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist