Healthcare Provider Details

I. General information

NPI: 1689209900
Provider Name (Legal Business Name): SOPHIE SHARON REECHER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E MAIN ST
EL CAJON CA
92020-4007
US

IV. Provider business mailing address

5886 N CL MYERS DR
BYRON IL
61010-9340
US

V. Phone/Fax

Practice location:
  • Phone: 619-515-2498
  • Fax:
Mailing address:
  • Phone: 815-978-3293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13338
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number63294
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: