Doctor Name: | MS. REBECCA PORTEOUS |
NPI Number: | 1659562791 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LCS18459 |
Business Practice Address: | 3135 Boeing Ave Ste A1 Mckinleyville, CA - 955199373 |
Business Phone Number: | 7076336145 |
Business Fax Number: | 7076336128 |
Mailing Address: | Po Box 992, ARCATA |
State: | CA |
Postal Code: | 955180992 |
Phone Number: | 7078221496 |
Fax Number: | 7078221406 |
NPI Enumeration Date: | 08/05/2007 |
NPI Last Update Date: | 03/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS18459 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |