Healthcare Provider Details

I. General information

NPI: 1609753086
Provider Name (Legal Business Name): KEICHEA L. REEVER ED.D., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 E FORHAN ST
LONG BEACH CA
90805-2245
US

IV. Provider business mailing address

326 E FORHAN ST
LONG BEACH CA
90805-2245
US

V. Phone/Fax

Practice location:
  • Phone: 562-668-1774
  • Fax:
Mailing address:
  • Phone: 562-668-1774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP9889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: