Provider Demographics
NPI:1982963997
Name:KOSKI, REBECCA (MA, LMFT #88826)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:KOSKI
Suffix:
Gender:F
Credentials:MA, LMFT #88826
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 MONTANA AVE # 179
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-1808
Mailing Address - Country:US
Mailing Address - Phone:310-985-4443
Mailing Address - Fax:909-595-1329
Practice Address - Street 1:1626 MONTANA AVE # 179
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-1808
Practice Address - Country:US
Practice Address - Phone:310-985-4443
Practice Address - Fax:909-595-1329
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88826106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist