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General NPI Number Information
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NPI Number | 1821986456
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Entity Type | Organization
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Legal Business Name | RESERA HEALTH, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 1401 21ST ST STE 11521
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 650-459-4078
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Fax | 650-481-9438
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Provider Business Mailing Address
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Address Line | 1401 21ST ST STE 11521
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 650-459-4078
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Fax | 650-481-9438
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Authorized Official
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Title or Position | FOUNDER, CEO
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Name | DR. EUN KYUNG JOANNE LEE
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Credential | MD, MS
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Telephone | 650-285-0299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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