MEDICARE: LINDA REAVES

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1649506361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA REAVES

Provider Business Mailing Address
First Line	:	6460 N SELLAND AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-0898
Country	:	US
Telephone Number	:	559-449-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	2745 N HUGHES AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93705-3726
Country	:	US
Telephone Number	:	559-449-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2009
Last Update Date	:	10/30/2009

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Directions to “ LINDA REAVES ” Practice Location

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