Provider Demographics
NPI:1871351791
Name:REID, CAROLYN PATRICIA (DOCTOR OF HEALTH SC)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:PATRICIA
Last Name:REID
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Gender:
Credentials:DOCTOR OF HEALTH SC
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Mailing Address - Street 1:100 CHURCH ST S STE A230
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1703
Mailing Address - Country:US
Mailing Address - Phone:203-737-2284
Mailing Address - Fax:
Practice Address - Street 1:415 KNOLLCREST DR STE 101
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0181
Practice Address - Country:US
Practice Address - Phone:530-392-4399
Practice Address - Fax:530-927-5353
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA64795363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant