Provider Demographics
NPI:1912450081
Name:HERRICK, REBEKAH ELIZABETH FELICE (PA-C)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:ELIZABETH FELICE
Last Name:HERRICK
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1595 SOQUEL DR STE 140
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1717
Practice Address - Country:US
Practice Address - Phone:831-462-4444
Practice Address - Fax:831-462-4488
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA53893363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant