Provider Demographics
NPI:1740090109
Name:TREADWAY, REBECCA ANN (ASW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:TREADWAY
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6323 BRACE RD
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-9206
Mailing Address - Country:US
Mailing Address - Phone:530-852-1461
Mailing Address - Fax:
Practice Address - Street 1:300 DEREK PL
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-7011
Practice Address - Country:US
Practice Address - Phone:916-773-7273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1071871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical