Provider Demographics
NPI:1558610469
Name:REYES, MARIANA (CD(DONA))
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 UNIVERSITY AVE APT 311
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1478
Mailing Address - Country:US
Mailing Address - Phone:561-762-9455
Mailing Address - Fax:
Practice Address - Street 1:1627 UNIVERSITY AVE APT 311
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-1478
Practice Address - Country:US
Practice Address - Phone:561-762-9455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula