Provider Demographics
NPI:1801039383
Name:REYES, DANIEL LEO JR (BA)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:LEO
Last Name:REYES
Suffix:JR
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4411
Mailing Address - Country:US
Mailing Address - Phone:415-621-5662
Mailing Address - Fax:415-621-5466
Practice Address - Street 1:440 9TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4411
Practice Address - Country:US
Practice Address - Phone:415-621-5662
Practice Address - Fax:415-621-5466
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor