Provider Demographics
NPI:1538727763
Name:RICKMAN, SLOANE REBECCA MCBRIDE
Entity type:Individual
Prefix:
First Name:SLOANE
Middle Name:REBECCA MCBRIDE
Last Name:RICKMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 RILEY AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-3727
Mailing Address - Country:US
Mailing Address - Phone:949-378-5701
Mailing Address - Fax:
Practice Address - Street 1:2 CIRCLE HILL CT
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-5902
Practice Address - Country:US
Practice Address - Phone:949-228-5681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35224103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist