Basic Information
| Provider Information | |||||||||
| NPI: | 1326557802 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOMPOINT | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | TERESA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M ED. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 728 DUNCANVILLE CT | ||||||||
| Address2: | |||||||||
| City: | CAMPBELL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950083148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503805160 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1171 HOMESTEAD RD STE 280 | ||||||||
| Address2: | |||||||||
| City: | SANTA CLARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950505486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083202590 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2017 | ||||||||
| LastUpdateDate: | 09/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.