Provider Demographics
NPI:1699730192
Name:LEVY, REBECCA (BSN)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN
Mailing Address - Street 1:130 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-5102
Mailing Address - Country:US
Mailing Address - Phone:760-806-5411
Mailing Address - Fax:
Practice Address - Street 1:130 CEDAR RD
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083
Practice Address - Country:US
Practice Address - Phone:760-806-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA652522163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse