Provider Demographics
NPI:1366537698
Name:REEVES, DENISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:REEVES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:BIGICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 895
Mailing Address - Street 2:
Mailing Address - City:CARDIFF BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:92007-0895
Mailing Address - Country:US
Mailing Address - Phone:760-635-3310
Mailing Address - Fax:760-230-9291
Practice Address - Street 1:511 SAXONY PL STE 101-C
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2871
Practice Address - Country:US
Practice Address - Phone:760-635-3310
Practice Address - Fax:760-230-9291
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042124A103T00000X
IL071007128103T00000X
CAPSY29995103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY29995OtherCA PSYCHOLOGY LICENSE NUMBER