Provider Demographics
NPI:1598749947
Name:REED, BRUCE RICHARDS (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:RICHARDS
Last Name:REED
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:MUIR ROAD (127A)
Mailing Address - Street 2:UC DAVIS ADC150
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553
Mailing Address - Country:US
Mailing Address - Phone:925-372-2485
Mailing Address - Fax:925-372-2884
Practice Address - Street 1:150 MUIR ROAD
Practice Address - Street 2:UC DAVIS ADC (127A)150 MUIR ROAD (127A)
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553
Practice Address - Country:US
Practice Address - Phone:925-372-2485
Practice Address - Fax:925-372-2884
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9895103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist