Doctor Name: | RICAFORT C REYES |
NPI Number: | 1033468483 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 9015 Murray Ave Suite 100 Gilroy, CA - 950203617 |
Business Phone Number: | 4088464719 |
Business Fax Number: | |
Mailing Address: | 29459 Margarita Ct, SANTA NELLA |
State: | CA |
Postal Code: | 953229694 |
Phone Number: | 4084995737 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2012 |
NPI Last Update Date: | 01/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |