Provider Demographics
NPI:1952603821
Name:WENDLER, REBECCA RACHAEL (LAC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:RACHAEL
Last Name:WENDLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-2415
Mailing Address - Country:US
Mailing Address - Phone:415-459-2160
Mailing Address - Fax:415-459-2160
Practice Address - Street 1:715 SEABRIGHT AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-3424
Practice Address - Country:US
Practice Address - Phone:415-286-2910
Practice Address - Fax:831-429-4139
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13917171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist