Provider Demographics
NPI:1275023293
Name:REINA, EVANGELINA (LCSW)
Entity Type:Individual
Prefix:
First Name:EVANGELINA
Middle Name:
Last Name:REINA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5479 E ABBEYFIELD ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3050
Mailing Address - Country:US
Mailing Address - Phone:562-498-5900
Mailing Address - Fax:562-498-5909
Practice Address - Street 1:5479 E ABBEYFIELD ST STE 3
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3050
Practice Address - Country:US
Practice Address - Phone:562-498-5900
Practice Address - Fax:562-498-5909
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical