Provider Demographics
NPI:1790543528
Name:REYES, ASHLEE VERENICE
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:VERENICE
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 ZANKER RD STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-2122
Mailing Address - Country:US
Mailing Address - Phone:408-752-1401
Mailing Address - Fax:888-420-6257
Practice Address - Street 1:2880 ZANKER RD STE 203
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-2122
Practice Address - Country:US
Practice Address - Phone:408-752-1401
Practice Address - Fax:888-420-6257
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician