Provider Demographics
NPI:1013748482
Name:REYES, CRISTINE GAIL SORIANO I
Entity type:Individual
Prefix:
First Name:CRISTINE GAIL
Middle Name:SORIANO
Last Name:REYES
Suffix:I
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 1:9129 FARMSTEAD CIR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-4399
Mailing Address - Country:US
Mailing Address - Phone:916-743-3995
Mailing Address - Fax:
Practice Address - Street 1:9129 FARMSTEAD CIR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-4399
Practice Address - Country:US
Practice Address - Phone:916-743-3995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide