Individual
REBECCA R KOLB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
550 N FLOWER ST BLDG 96, SANTA ANA, CA 92703-2361
(909) 593-2581
Mailing address
5054 CRESTVIEW PL, RANCHO CUCAMONGA, CA 91701-1262
(951) 288-2473
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
605525
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95010092
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7565A
OUTPATIENT MENTAL HEALTH
CA
Enumeration date
10/24/2011
Last updated
01/18/2019
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