Provider Demographics
NPI:1043520729
Name:NUPP, REBEKAH LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:LYNN
Last Name:NUPP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2444 S ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CA
Mailing Address - Zip Code:90058-1334
Mailing Address - Country:US
Mailing Address - Phone:916-516-4989
Mailing Address - Fax:
Practice Address - Street 1:2444 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CA
Practice Address - Zip Code:90058-1334
Practice Address - Country:US
Practice Address - Phone:916-516-4989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA759021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical