Provider Demographics
NPI:1013436708
Name:SEGURA, REBECCA QUIROZ (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:QUIROZ
Last Name:SEGURA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MARIE
Other - Last Name:QUIROZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1940 E DEERE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5718
Mailing Address - Country:US
Mailing Address - Phone:714-293-5310
Mailing Address - Fax:
Practice Address - Street 1:1001 N. TUSTIN AVE.
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705
Practice Address - Country:US
Practice Address - Phone:714-953-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA766681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical