Provider Demographics
NPI:1528074473
Name:REED, CHARLES GARNER (PHD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:GARNER
Last Name:REED
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2254 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1750
Mailing Address - Country:US
Mailing Address - Phone:415-750-2236
Mailing Address - Fax:415-750-6660
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:VA MEDICAL CENTER, AUDIOLOGY (126)
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-750-6660
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 5413235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist