Provider Demographics
NPI:1750756714
Name:HAHN-HOOTEN, REBECCA (LMFT 115545)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HAHN-HOOTEN
Suffix:
Gender:F
Credentials:LMFT 115545
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 N MOUNTAIN AVE STE 290
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-2114
Mailing Address - Country:US
Mailing Address - Phone:951-444-1647
Mailing Address - Fax:
Practice Address - Street 1:1406 NORTH CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762
Practice Address - Country:US
Practice Address - Phone:951-444-1647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF78251101YM0800X
CAIMF 78251106H00000X
CA115545101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist