Provider Demographics
NPI:1043880750
Name:REECE, CHARLA CAYE (AGACNP)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:CAYE
Last Name:REECE
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 VALLEY CREST DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-7442
Mailing Address - Country:US
Mailing Address - Phone:760-525-3512
Mailing Address - Fax:
Practice Address - Street 1:703 VALLEY CREST DR
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-7442
Practice Address - Country:US
Practice Address - Phone:760-525-3512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-26
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017311363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care