Provider Demographics
NPI:1992121339
Name:REECE, CALLIE KALANI (LMFT)
Entity type:Individual
Prefix:MRS
First Name:CALLIE
Middle Name:KALANI
Last Name:REECE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:CALLIE
Other - Middle Name:KALANI
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 16252
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92176-6252
Mailing Address - Country:US
Mailing Address - Phone:619-818-7628
Mailing Address - Fax:
Practice Address - Street 1:2300 BOSWELL RD STE 245
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3539
Practice Address - Country:US
Practice Address - Phone:619-549-0329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA119116106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106H00000XOther106H00000X
CA390200000XOtherSTUDENT MENTAL HEALTH
CA106H00000XOther106H00000X.