Provider Demographics
NPI:1720392434
Name:O'CALLAGHAN, REBECCA (MS, OTR/L, SWC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:O'CALLAGHAN
Suffix:
Gender:F
Credentials:MS, OTR/L, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8795 FOLSOM BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-3720
Mailing Address - Country:US
Mailing Address - Phone:916-834-4379
Mailing Address - Fax:
Practice Address - Street 1:6768 9TH AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-2106
Practice Address - Country:US
Practice Address - Phone:916-834-4379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT7936225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics