Individual
REBECCA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15460 SHERMAN WAY APT 1315, VAN NUYS, CA 91406-4380
(628) 224-5590
Mailing address
15460 SHERMAN WAY APT 1315, VAN NUYS, CA 91406-4380
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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