Reicks, Edward William

Reicks, Edward William is an sole proprietor health care provider with primary practice located at 1440 N Harbor Blvd Suite 127, Fullerton CA 92835-4114. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Reicks, Edward William can be contacted via phone (714) 879-7091.

Contact Information

Primary practice address
1440 N Harbor Blvd Suite 127 Fullerton CA 92835-4114
Fax: (714) 441-0914
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY 11010 California

Profile Details

NPI number 1083768733
LBN Legal business name Reicks, Edward William
Credentials PH,D,
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 22nd, 2007
Last updated Feb 2nd, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083768733 NPPES
California Other OPL 11010 USBH
California Other PSY 11010 USBH
California MEDICAID PSY11010 USBH
California MEDICAID CP11010 USBH

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