Provider Demographics
NPI:1952619843
Name:PEARCE, REBECCA MABEY (RD)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:MABEY
Last Name:PEARCE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11300 EXPOSITION BLVD
Mailing Address - Street 2:APT #407
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-3029
Mailing Address - Country:US
Mailing Address - Phone:310-709-7400
Mailing Address - Fax:
Practice Address - Street 1:11300 EXPOSITION BLVD
Practice Address - Street 2:APT #407
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-3029
Practice Address - Country:US
Practice Address - Phone:310-709-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01009719133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered