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NPI Code Detail

MEDICARE: MS. PATRICIA REYNOLDS-MEADE MA, LAADC, M-RAS

MEDICARE: MS. PATRICIA REYNOLDS-MEADE MA, LAADC, M-RAS
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLR1500112CA

General Provider Information

NPI Number : 1457790271
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA REYNOLDS-MEADE MA, LAADC, M-RAS
Provider Business Mailing Address
First Line : 1001 GRAND AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95838-3512
Country : US
Telephone Number : 916-929-1951
Fax Number :
Provider Business Practice Location Address
First Line : 1001 GRAND AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95838-3512
Country : US
Telephone Number : 916-929-1951
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2013
Last Update Date : 12/18/2013

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