Healthcare Provider Details

I. General information

NPI: 1801539291
Provider Name (Legal Business Name): SACHI LOVELY REEVES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 W SANTA CLARA ST
SAN JOSE CA
95113-1815
US

IV. Provider business mailing address

4825 GENEVA AVE
CONCORD CA
94521-2122
US

V. Phone/Fax

Practice location:
  • Phone: 510-372-3464
  • Fax:
Mailing address:
  • Phone: 510-372-3464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License Number95203402
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: