Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 76822 | CA |
NPI | 1003049495 |
---|---|
Provider Name | Kimberlee Julianne Reese |
First Address | San Leandro, CA 94578-1132 |
Second Address | San Leandro, CA 94578-1132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2009 |
Last Update Date | 08/06/2017 |