Provider Demographics
NPI:1821276528
Name:REECE, KIMBERLEE JOYELLE (LAC)
Entity Type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:JOYELLE
Last Name:REECE
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 1:47 DESVIO CT
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-4230
Mailing Address - Country:US
Mailing Address - Phone:415-515-9668
Mailing Address - Fax:
Practice Address - Street 1:980 LINDA MAR BLVD
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-3542
Practice Address - Country:US
Practice Address - Phone:650-355-3600
Practice Address - Fax:650-355-3600
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12103171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist