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General NPI Number Information
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NPI Number | 1558687475
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Entity Type | Individual
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Provider Name | JACQUELINE J REAMS FMHPNP
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Gender | Female
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 1450 TREAT BLVD # 250
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City | WALNUT CREEK
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State | CA
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Zip | 94597-2168
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Country | US
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Telephone | 925-296-9860
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SAINT VINCENTS DR
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City | SAN RAFAEL
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State | CA
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Zip | 94903-1504
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Country | US
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Telephone | 415-507-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 401596
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP95006168
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License Number State | CA
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