Provider Demographics
NPI:1568773612
Name:REEVES, LUZONITA V
Entity Type:Individual
Prefix:
First Name:LUZONITA
Middle Name:V
Last Name:REEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2541
Mailing Address - Country:US
Mailing Address - Phone:619-477-8802
Mailing Address - Fax:619-477-8804
Practice Address - Street 1:909 E 8TH ST
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2541
Practice Address - Country:US
Practice Address - Phone:619-477-8802
Practice Address - Fax:619-477-8804
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171100000X, 172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
No171100000XOther Service ProvidersAcupuncturist