Provider Demographics
NPI:1982266771
Name:LOVEJOY, REBEKAH D
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:D
Last Name:LOVEJOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:D
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6204 AVENIDA GANSO
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2064
Mailing Address - Country:US
Mailing Address - Phone:650-400-1074
Mailing Address - Fax:
Practice Address - Street 1:6204 AVENIDA GANSO
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-2064
Practice Address - Country:US
Practice Address - Phone:650-400-1074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
CA130001106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No172V00000XOther Service ProvidersCommunity Health Worker