Provider Demographics
NPI:1679985287
Name:REED, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:REED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47647 CALEO BAY DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-8854
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50225 HARRISON ST
Practice Address - Street 2:SUITE 103
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1527
Practice Address - Country:US
Practice Address - Phone:760-698-8183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-30
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10365225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant