Provider Demographics
NPI:1487759510
Name:WATSON, REBECCA (BSW)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5140 BARONA WAY
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-4004
Mailing Address - Country:US
Mailing Address - Phone:619-886-2378
Mailing Address - Fax:
Practice Address - Street 1:5140 BARONA WAY
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-4004
Practice Address - Country:US
Practice Address - Phone:619-886-2378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker