Provider Demographics
NPI:1912770652
Name:CHILLES, REBECCA ANNE (RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:CHILLES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANNE CHILLES
Other - Last Name:CHAVEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:25727 MCBEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3704
Mailing Address - Country:US
Mailing Address - Phone:661-200-1083
Mailing Address - Fax:661-200-1076
Practice Address - Street 1:25727 MCBEAN PKWY
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-3704
Practice Address - Country:US
Practice Address - Phone:661-200-1083
Practice Address - Fax:661-200-1076
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA828625163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse