Provider Demographics
NPI:1538706163
Name:REESE, AMY CATHERINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:CATHERINE
Last Name:REESE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 ROYAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-9215
Mailing Address - Country:US
Mailing Address - Phone:530-919-0094
Mailing Address - Fax:
Practice Address - Street 1:359 MAIN ST
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5605
Practice Address - Country:US
Practice Address - Phone:530-622-3186
Practice Address - Fax:530-622-3224
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20385183500000X
CA81621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist