Provider Demographics
NPI:1558442665
Name:VIGARS, REBECCA (LMFT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:VIGARS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 SCOTTS VALLEY DR
Mailing Address - Street 2:SUITE J
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-4541
Mailing Address - Country:US
Mailing Address - Phone:831-338-0966
Mailing Address - Fax:831-461-9700
Practice Address - Street 1:4340 SCOTTS VALLEY DR
Practice Address - Street 2:SUITE J
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-4541
Practice Address - Country:US
Practice Address - Phone:831-338-0966
Practice Address - Fax:831-461-9700
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 34978101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health