Provider Demographics
NPI:1013599299
Name:REEVES, ESTEE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ESTEE
Middle Name:
Last Name:REEVES
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BUDD AVE APT H1
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-4013
Mailing Address - Country:US
Mailing Address - Phone:831-840-6743
Mailing Address - Fax:
Practice Address - Street 1:3790 RED OAK WAY
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-1133
Practice Address - Country:US
Practice Address - Phone:650-482-2414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30754235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist