Provider Demographics
NPI:1225222102
Name:REESE, DAWN NICHOL (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:NICHOL
Last Name:REESE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 472093
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94147-2093
Mailing Address - Country:US
Mailing Address - Phone:916-832-5803
Mailing Address - Fax:
Practice Address - Street 1:1028 GIRARD RD APT 422
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94129-6506
Practice Address - Country:US
Practice Address - Phone:916-832-5803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA548896163W00000X, 163WA2000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator