Provider Demographics
NPI:1114197217
Name:REYNA, REGAN HORNER
Entity Type:Individual
Prefix:
First Name:REGAN
Middle Name:HORNER
Last Name:REYNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REGAN
Other - Middle Name:
Other - Last Name:HORNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 GRAND AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-5054
Mailing Address - Country:US
Mailing Address - Phone:510-834-2443
Mailing Address - Fax:510-834-1548
Practice Address - Street 1:401 GRAND AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-5054
Practice Address - Country:US
Practice Address - Phone:510-834-2443
Practice Address - Fax:510-834-1548
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator