Basic Information
| Provider Information | |||||||||
| NPI: | 1467117226 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REHARD | ||||||||
| FirstName: | CARLEY | ||||||||
| MiddleName: | CHRISTINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 864 E SANTA CLARA ST | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930012939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056431446 | ||||||||
| FaxNumber: | 8056430271 | ||||||||
| Practice Location | |||||||||
| Address1: | 864 E SANTA CLARA ST | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930012939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056431446 | ||||||||
| FaxNumber: | 8056430271 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2021 | ||||||||
| LastUpdateDate: | 10/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 110132 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.