Provider Demographics
NPI:1679143952
Name:HOTZEL, REBECCA (LMFT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HOTZEL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3013 HIGHLAND AVE APT C
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3982
Mailing Address - Country:US
Mailing Address - Phone:909-503-2716
Mailing Address - Fax:
Practice Address - Street 1:1001 6TH ST STE 150
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6755
Practice Address - Country:US
Practice Address - Phone:310-406-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124193101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty