Healthcare Provider Details

I. General information

NPI: 1932049822
Provider Name (Legal Business Name): HEATHER ROSE REES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 Q ST
SACRAMENTO CA
95811-5705
US

IV. Provider business mailing address

2105 17TH ST
SACRAMENTO CA
95818-1514
US

V. Phone/Fax

Practice location:
  • Phone: 916-234-0359
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberL10123
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: