Provider Demographics
NPI:1982396073
Name:VALLE, REBEKAH A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REBEKAH
Middle Name:A
Last Name:VALLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16826 TURK DR
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-4946
Mailing Address - Country:US
Mailing Address - Phone:626-344-8773
Mailing Address - Fax:
Practice Address - Street 1:595 E COLORADO BLVD STE 302
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2021
Practice Address - Country:US
Practice Address - Phone:626-344-8773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical