Provider Demographics
NPI:1639936818
Name:REYES, CHEYENNE MERIAH
Entity Type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:MERIAH
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHEYENNE
Other - Middle Name:MERIAH
Other - Last Name:BILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1927
Mailing Address - Street 2:
Mailing Address - City:BIG BEAR LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92315-1927
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:41945 BIG BEAR BLVD STE 222
Practice Address - Street 2:
Practice Address - City:BIG BEAR LAKE
Practice Address - State:CA
Practice Address - Zip Code:92315-2030
Practice Address - Country:US
Practice Address - Phone:909-866-5070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker