Provider Demographics
NPI:1285424390
Name:REESE, ERIN NICOLE (CBD, CSE, CL, ABS)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:NICOLE
Last Name:REESE
Suffix:
Gender:F
Credentials:CBD, CSE, CL, ABS
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:NICOLE
Other - Last Name:MULLANEY-REESE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CBD, CSE, CL, ABS
Mailing Address - Street 1:565 PIER AVE UNIT 1208
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-8271
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24520 HAWTHORNE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6843
Practice Address - Country:US
Practice Address - Phone:424-571-9487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X, 174H00000X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No171400000XOther Service ProvidersHealth & Wellness Coach