Individual
MS. REBECCA LYNN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP MS
Contact information
Practice address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 576-1700
Mailing address
4512 MAX DR, SAN DIEGO, CA 92115-3113
(619) 563-3996
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
376266
CA
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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