Provider Demographics
NPI:1396638144
Name:REBECCA GILLOGLY PSYCHOLOGIST A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:REBECCA GILLOGLY PSYCHOLOGIST A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLOGLY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:805-791-6372
Mailing Address - Street 1:2413 I ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4208
Mailing Address - Country:US
Mailing Address - Phone:805-791-6372
Mailing Address - Fax:
Practice Address - Street 1:3102 O ST STE 8
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7179
Practice Address - Country:US
Practice Address - Phone:805-791-6372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty