Provider Demographics
NPI:1154192326
Name:WOOD, REBECCA FRANCES (AMFT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:FRANCES
Last Name:WOOD
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7171 WARNER AVE SUITE
Mailing Address - Street 2:SUITE B #484
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-5429
Mailing Address - Country:US
Mailing Address - Phone:714-853-3247
Mailing Address - Fax:
Practice Address - Street 1:2900 BRISTOL ST STE B205
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5948
Practice Address - Country:US
Practice Address - Phone:855-867-5551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA403545106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist