Provider Demographics
NPI:1356371454
Name:KLOKER, REBECCA JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JEAN
Last Name:KLOKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7956 GLENDA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-2225
Mailing Address - Country:US
Mailing Address - Phone:765-969-9631
Mailing Address - Fax:
Practice Address - Street 1:3810 ROSIN CT STE 180
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1658
Practice Address - Country:US
Practice Address - Phone:765-969-9631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058972A2084P0800X
CAC1457332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200309650Medicaid
IN340910GGMedicare ID - Type Unspecified