Provider Demographics
NPI:1801028642
Name:REYES, TRINH THI (LCSW)
Entity Type:Individual
Prefix:
First Name:TRINH
Middle Name:THI
Last Name:REYES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TRINH
Other - Middle Name:THI
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2500 FAIRMONT DR
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1005
Mailing Address - Country:US
Mailing Address - Phone:510-667-3000
Mailing Address - Fax:
Practice Address - Street 1:2500 FAIRMONT DR
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-1005
Practice Address - Country:US
Practice Address - Phone:510-667-3000
Practice Address - Fax:510-667-3001
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW644581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical