Provider Demographics
NPI:1467774489
Name:REYES, JOVITA BARRON (MA, SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOVITA
Middle Name:BARRON
Last Name:REYES
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:591 MCCRAY ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-2224
Mailing Address - Country:US
Mailing Address - Phone:831-630-9044
Mailing Address - Fax:831-637-5925
Practice Address - Street 1:591 MCCRAY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-2224
Practice Address - Country:US
Practice Address - Phone:831-630-9044
Practice Address - Fax:831-637-5925
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP13949235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist