Provider Demographics
NPI:1063824472
Name:REID, STEVEN (RAS, FAC,CSC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:REID
Suffix:
Gender:M
Credentials:RAS, FAC,CSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1723
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93902-1723
Mailing Address - Country:US
Mailing Address - Phone:831-636-4020
Mailing Address - Fax:
Practice Address - Street 1:1131 SAN FELIPE RD
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-2800
Practice Address - Country:US
Practice Address - Phone:831-636-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1007191444101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)