Provider Demographics
NPI:1033651310
Name:REYES, KARLA
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:
Other - Last Name:COCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10417 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAMONT
Mailing Address - State:CA
Mailing Address - Zip Code:93241-1726
Mailing Address - Country:US
Mailing Address - Phone:661-845-5100
Mailing Address - Fax:
Practice Address - Street 1:7839 BURGUNDY AVE
Practice Address - Street 2:
Practice Address - City:LAMONT
Practice Address - State:CA
Practice Address - Zip Code:93241-1338
Practice Address - Country:US
Practice Address - Phone:661-845-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-17
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108201101YM0800X
CA126035106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health