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NPI Code Detail

MEDICARE: MAITE REECE MA, PSYD

MEDICARE: MAITE REECE MA, PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist36480CA

General Provider Information

NPI Number : 1023851334
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAITE REECE MA, PSYD
Provider Business Mailing Address
First Line : 443 E PAYSON ST
Second Line :
City : GLENDORA
State : CA
Zip : 91740-5627
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : PO BOX 748465
Second Line :
City : ATLANTA
State : GA
Zip : 30374-8465
Country : US
Telephone Number : 855-284-7483
Fax Number : 617-807-0958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2024
Last Update Date : 02/02/2026

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