Doctor Name: | MS. ERICA DIANE REYES |
NPI Number: | 1033319405 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | Lausd-school Mental Health Services 3099 704 West 8th Street San Pedro, CA - 90731 |
Business Phone Number: | 3108327545 |
Business Fax Number: | |
Mailing Address: | Lausd-school Mental Health Services 3099, 704 West 8th Street SAN PEDRO |
State: | CA |
Postal Code: | 90731 |
Phone Number: | 3108327545 |
Fax Number: | |
NPI Enumeration Date: | 07/23/2007 |
NPI Last Update Date: | 07/23/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |