Provider Demographics
NPI:1699800854
Name:SCHRAVEN, REBECCA (PT)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:SCHRAVEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 421
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2107
Mailing Address - Country:US
Mailing Address - Phone:310-275-4137
Mailing Address - Fax:310-274-1815
Practice Address - Street 1:9735 WILSHIRE BLVD
Practice Address - Street 2:SUITE 421
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2107
Practice Address - Country:US
Practice Address - Phone:310-275-4137
Practice Address - Fax:310-274-1815
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT14382251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT1438AMedicare ID - Type UnspecifiedINDIVIDUAL PT