Provider Demographics
NPI:1396846820
Name:REIS, RENE (MFT)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:REIS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-3812
Mailing Address - Country:US
Mailing Address - Phone:916-447-5774
Mailing Address - Fax:916-446-8070
Practice Address - Street 1:930 G ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-1802
Practice Address - Country:US
Practice Address - Phone:916-441-2933
Practice Address - Fax:916-446-8070
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36542106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist