Healthcare Provider Details

I. General information

NPI: 1821276528
Provider Name (Legal Business Name): KIMBERLEE JOYELLE REECE L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 LINDA MAR BLVD
PACIFICA CA
94044-3542
US

IV. Provider business mailing address

47 DESVIO CT
PACIFICA CA
94044-4230
US

V. Phone/Fax

Practice location:
  • Phone: 650-355-3600
  • Fax: 650-355-3600
Mailing address:
  • Phone: 415-515-9668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12103
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: