Provider Demographics
NPI:1891905303
Name:ABIKO, GENEVA REYNAGA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GENEVA
Middle Name:REYNAGA
Last Name:ABIKO
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 1:14150 NE 20TH ST # F1-126
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3700
Mailing Address - Country:US
Mailing Address - Phone:703-493-1550
Mailing Address - Fax:
Practice Address - Street 1:14150 NE 20TH ST # F1-126
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3700
Practice Address - Country:US
Practice Address - Phone:703-493-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810006770103TC0700X
WAPY61346138103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical