Provider Demographics
NPI:1134890007
Name:REXROAT, REBECCA (HAD #8451)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:REXROAT
Suffix:
Gender:F
Credentials:HAD #8451
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 DOUGLAS BLVD STE 992
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3639
Mailing Address - Country:US
Mailing Address - Phone:559-727-1118
Mailing Address - Fax:
Practice Address - Street 1:1850 DOUGLAS BLVD STE 992
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3639
Practice Address - Country:US
Practice Address - Phone:559-727-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8451237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist