Provider Demographics
NPI:1003697681
Name:REYNOLDS, JAMEKA NACOLE (MSW)
Entity Type:Individual
Prefix:
First Name:JAMEKA
Middle Name:NACOLE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 E BUCKTHORN ST APT 6
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-0932
Mailing Address - Country:US
Mailing Address - Phone:562-682-9312
Mailing Address - Fax:
Practice Address - Street 1:600 N ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-2605
Practice Address - Country:US
Practice Address - Phone:213-200-7648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker