Doctor Name: | JULIAN REYES |
NPI Number: | 1063727105 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | ASW32706 |
Business Practice Address: | 17707 Studebaker Rd Cerritos, CA - 907032640 |
Business Phone Number: | 5624020688 |
Business Fax Number: | 5624023032 |
Mailing Address: | 17707 Studebaker Rd, CERRITOS |
State: | CA |
Postal Code: | 907032640 |
Phone Number: | 5624020688 |
Fax Number: | 5624023032 |
NPI Enumeration Date: | 08/12/2010 |
NPI Last Update Date: | 07/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | ASW32706 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |