Provider Demographics
NPI:1699890947
Name:HEDRICK, REBECCA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARIE
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8730 ALDEN DR.
Mailing Address - Street 2:STE E137
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-423-3465
Mailing Address - Fax:310-423-8268
Practice Address - Street 1:8730 GRACIE ALLEN DR
Practice Address - Street 2:THALLIANS STE E137
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3811
Practice Address - Country:US
Practice Address - Phone:310-423-3465
Practice Address - Fax:310-423-8268
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA865442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry