Provider Demographics
NPI:1134793797
Name:HARRIS, REBECCA HAYES (DC)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:HAYES
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 BURBANK ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-2439
Mailing Address - Country:US
Mailing Address - Phone:503-954-9327
Mailing Address - Fax:
Practice Address - Street 1:300 TARAVAL ST SUITE A
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1953
Practice Address - Country:US
Practice Address - Phone:415-843-1492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor