Provider Demographics
NPI:1841532413
Name:REEVES, VERA LEE (FNP)
Entity type:Individual
Prefix:MS
First Name:VERA
Middle Name:LEE
Last Name:REEVES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:VERA
Other - Middle Name:LEE
Other - Last Name:MEDLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1855 N FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-1620
Mailing Address - Country:US
Mailing Address - Phone:626-398-6300
Mailing Address - Fax:626-398-6300
Practice Address - Street 1:1855 N FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1620
Practice Address - Country:US
Practice Address - Phone:626-398-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA561031261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility