Basic Information
| Provider Information | |||||||||
| NPI: | 1972987592 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | APONTE | ||||||||
| FirstName: | REBECCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 331 WHEDBEE ST | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805242935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155154213 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10333 EL CAMINO REAL | ||||||||
| Address2: | |||||||||
| City: | ATASCADERO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054682188 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2015 | ||||||||
| LastUpdateDate: | 07/19/2018 | ||||||||
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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 | 103TC0700X | 30194 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.