Provider Demographics
NPI:1851454425
Name:REYHAN, ANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:REYHAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14708 PIPELINE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1296
Mailing Address - Country:US
Mailing Address - Phone:909-393-8585
Mailing Address - Fax:909-393-8566
Practice Address - Street 1:14708 PIPELINE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1296
Practice Address - Country:US
Practice Address - Phone:909-393-8585
Practice Address - Fax:909-393-8566
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23145106H00000X
CA23987103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FD793AMedicare PIN