Provider Demographics
NPI:1750534467
Name:REKART, JOHN ARTHUR (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ARTHUR
Last Name:REKART
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37702 LOGAN DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5868
Mailing Address - Country:US
Mailing Address - Phone:510-299-6127
Mailing Address - Fax:
Practice Address - Street 1:37702 LOGAN DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5868
Practice Address - Country:US
Practice Address - Phone:510-299-6127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16834103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist