Provider Demographics
NPI:1023481660
Name:MANKOWSKI, REBECCA MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE
Last Name:MANKOWSKI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HOWE AVE. BLDG. 500
Mailing Address - Street 2:SUITE 510
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-4731
Mailing Address - Country:US
Mailing Address - Phone:916-520-4282
Mailing Address - Fax:
Practice Address - Street 1:650 HOWE AVE. BLDG. 500
Practice Address - Street 2:SUITE 510
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-4731
Practice Address - Country:US
Practice Address - Phone:916-520-4282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90266106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist