Provider Demographics
NPI:1568869782
Name:REEVES, AMALIA (LAC)
Entity Type:Individual
Prefix:
First Name:AMALIA
Middle Name:
Last Name:REEVES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S CALIFORNIA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1636
Mailing Address - Country:US
Mailing Address - Phone:650-470-0008
Mailing Address - Fax:650-470-0009
Practice Address - Street 1:220 S CALIFORNIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1636
Practice Address - Country:US
Practice Address - Phone:650-470-0008
Practice Address - Fax:650-470-0009
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16121171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist