Provider Demographics
NPI:1982213492
Name:REYES, TANYA ALEJANDRA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:ALEJANDRA
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 1:8933 PANAMA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAMONT
Mailing Address - State:CA
Mailing Address - Zip Code:93241-1649
Mailing Address - Country:US
Mailing Address - Phone:661-845-3717
Mailing Address - Fax:661-845-3385
Practice Address - Street 1:8933 PANAMA RD STE 101
Practice Address - Street 2:
Practice Address - City:LAMONT
Practice Address - State:CA
Practice Address - Zip Code:93241-1649
Practice Address - Country:US
Practice Address - Phone:661-845-3717
Practice Address - Fax:661-845-3385
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator