Provider Demographics
NPI:1396113791
Name:APANA, REBECCA (PSYD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:APANA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 N SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-1651
Mailing Address - Country:US
Mailing Address - Phone:760-330-9175
Mailing Address - Fax:
Practice Address - Street 1:2405 N SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-1651
Practice Address - Country:US
Practice Address - Phone:760-330-9175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15536103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist