Provider Demographics
NPI:1225366784
Name:REED, DAVID (LMFT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:REED
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 1436
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1052
Mailing Address - Country:US
Mailing Address - Phone:760-424-9747
Mailing Address - Fax:
Practice Address - Street 1:9915 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1606
Practice Address - Country:US
Practice Address - Phone:760-424-9747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36469106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36469OtherSTATE OF CALIFORNIA LICENSED MARRIAGE AND FAMILY THERAPIST