Provider Demographics
NPI:1700117447
Name:REACH, DAVE (RN)
Entity Type:Individual
Prefix:MR
First Name:DAVE
Middle Name:
Last Name:REACH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 G ST
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-4014
Mailing Address - Country:US
Mailing Address - Phone:707-465-0374
Mailing Address - Fax:707-465-0359
Practice Address - Street 1:343 G ST
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-4014
Practice Address - Country:US
Practice Address - Phone:707-465-0374
Practice Address - Fax:707-465-0359
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health