Active NPI
Joan Menden Reese, M.D.
- Pediatric Neurodevelopmental Disabilities Physician
- San Diego, CA
National Provider Identifier
1659495695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Neurodevelopmental Disabilities Physician
- License
- G45782
- Practice address
- 4355 Ruffin Rd
San Diego, CA 92123-4306 - Phone
- (858) 576-2973
- Fax
- (858) 496-4303
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | G45782 | CA | Primary |
Addresses
Primary practice location
4355 Ruffin Rd
San Diego, CA 92123-4306
Mailing address
4355 Ruffin Rd
San Diego, CA 92123-4306
Phone (858) 576-2973
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CMS200039 | Other | CA | CCS GHPP PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G45782 | CA | MD | Pediatric Neurodevelopmental Disabilities Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659495695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4355 RUFFIN RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234306",
"telephone_number": "858-576-2973",
"fax_number": "858-496-4303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4355 RUFFIN RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234306",
"telephone_number": "858-576-2973",
"fax_number": "858-496-4303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REESE",
"first_name": "JOAN",
"middle_name": "MENDEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0008X",
"taxonomy_group": "",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": "CA",
"license": "G45782",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCS GHPP PROVIDER NUMBER",
"identifier": "CMS200039",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.