Provider Demographics
NPI:1386824753
Name:FERRAZ, REYNALD JOSEPH SAN PEDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:REYNALD JOSEPH
Middle Name:SAN PEDRO
Last Name:FERRAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 W HORIZON RIDGE PKWY # 234
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4477
Mailing Address - Country:US
Mailing Address - Phone:702-943-8820
Mailing Address - Fax:
Practice Address - Street 1:4000 ORANGE ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3613
Practice Address - Country:US
Practice Address - Phone:951-955-1643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV123702084P0800X
AZ465192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry