Provider Demographics
NPI:1306154604
Name:SCHILLECI, REBECCA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:SCHILLECI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6832 AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4067
Mailing Address - Country:US
Mailing Address - Phone:714-848-2781
Mailing Address - Fax:
Practice Address - Street 1:101 LAGUNA RD
Practice Address - Street 2:SUITE A
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3634
Practice Address - Country:US
Practice Address - Phone:714-879-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19074363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical