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NPI Code Detail

MEDICARE: DR. JANICE LYNN REEVES PHD

MEDICARE: DR. JANICE LYNN REEVES PHD
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
1103TC0700XClinical PsychologistPSY12416CA

General Provider Information

NPI Number : 1790726263
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANICE LYNN REEVES PHD
Provider Business Mailing Address
First Line : 3101 4TH AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-5802
Country : US
Telephone Number : 619-688-0887
Fax Number : 619-223-3971
Provider Business Practice Location Address
First Line : 3101 4TH AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-5802
Country : US
Telephone Number : 619-688-0887
Fax Number : 619-223-3971
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 07/21/2022

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