Individual
REBECCA SPRAGUE
Active
Individual
REBECCA SPRAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPC
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
11828
CA
207RC0000X
Cardiovascular Disease Physician
Primary
NP11828
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0068230
—
CA
05
—
GR0068231
—
CA
05
—
GR0068232
—
CA
05
—
GR0068233
—
CA
05
—
GR0068235
—
CA
05
—
GR006823B
—
CA
05
—
RN314798
—
CA
01
—
ZZZ47673Z
BLUE SHIELD
CA
01
—
ZZZ47675Z
BLUE SHIELD
CA
01
—
ZZZ47676Z
BLUE SHIELD
CA
01
—
ZZZ62306Z
BLUE SHIELD
CA
Enumeration date
11/28/2006
Last updated
01/30/2008
Update your record
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