Provider Demographics
NPI:1114227147
Name:REYES, VERONICA M (MSW)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:M
Last Name:REYES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:VERONICA
Other - Middle Name:M
Other - Last Name:ZAVALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1885
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90251-1885
Mailing Address - Country:US
Mailing Address - Phone:310-502-6235
Mailing Address - Fax:
Practice Address - Street 1:12360 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4324
Practice Address - Country:US
Practice Address - Phone:562-281-0305
Practice Address - Fax:562-281-0309
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator