Provider Demographics
NPI:1346967171
Name:REYES MUNGUIA, MARIA (AMFT, APCC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:REYES MUNGUIA
Suffix:
Gender:F
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:33423 7TH ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-2301
Mailing Address - Country:US
Mailing Address - Phone:510-857-4034
Mailing Address - Fax:
Practice Address - Street 1:2000 KAMMERER AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-3016
Practice Address - Country:US
Practice Address - Phone:855-757-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130809106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist