Provider Demographics
NPI:1255133955
Name:BONE, REBECCA (PHD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BONE
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5951 JEFFERSON ST NE STE C
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3450
Mailing Address - Country:US
Mailing Address - Phone:505-247-4900
Mailing Address - Fax:505-933-6373
Practice Address - Street 1:5951 JEFFERSON ST NE STE C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3450
Practice Address - Country:US
Practice Address - Phone:505-247-4900
Practice Address - Fax:505-933-6373
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPSY1697103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist