Provider Demographics
NPI:1144382987
Name:REEG, JESSICA (LMFT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:REEG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:YESSICA
Other - Middle Name:INETT
Other - Last Name:MONTANEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:IMF
Mailing Address - Street 1:41002 COUNTY CENTER DR STE 320
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-6027
Mailing Address - Country:US
Mailing Address - Phone:951-600-6350
Mailing Address - Fax:
Practice Address - Street 1:41002 COUNTY CENTER DR STE 320
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6027
Practice Address - Country:US
Practice Address - Phone:951-600-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124306106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9477OtherMEDICA PROVIDER NUMBER