Provider Demographics
NPI:1962981985
Name:FECHNER, REBEKAH ANN (MS)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:ANN
Last Name:FECHNER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 536
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:CA
Mailing Address - Zip Code:95255-0536
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6464 LONE BARN RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:CA
Practice Address - Zip Code:95684-9225
Practice Address - Country:US
Practice Address - Phone:916-850-0305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2019-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist