Provider Demographics
NPI:1841890365
Name:DUCHATEAU, REBEKAH JANE (CPM, LM)
Entity type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:JANE
Last Name:DUCHATEAU
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:JANE
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPM, LM
Mailing Address - Street 1:6258 TUJUNGA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606
Mailing Address - Country:US
Mailing Address - Phone:760-978-7324
Mailing Address - Fax:
Practice Address - Street 1:6258 TUJUNGA AVE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606
Practice Address - Country:US
Practice Address - Phone:760-978-7324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM611176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife