Basic Information
| Provider Information | |||||||||
| NPI: | 1093843427 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCRAFFORD | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | JANE HERREMAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2542 NE COURTNEY DR | ||||||||
| Address2: | |||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977017685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417067730 | ||||||||
| FaxNumber: | 5417064760 | ||||||||
| Practice Location | |||||||||
| Address1: | 2600 NE NEFF RD | ||||||||
| Address2: | |||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977016337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417066843 | ||||||||
| FaxNumber: | 5415983444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2007 | ||||||||
| LastUpdateDate: | 04/24/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 1930 | OR | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.