Provider Demographics
NPI:1295811362
Name:REYES-OSORIO, OSMARA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:OSMARA
Middle Name:
Last Name:REYES-OSORIO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 DEEP VALLEY DR STE 207
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3654
Mailing Address - Country:US
Mailing Address - Phone:310-625-4406
Mailing Address - Fax:
Practice Address - Street 1:827 DEEP VALLEY DRIVE EAST
Practice Address - Street 2:#207
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274
Practice Address - Country:US
Practice Address - Phone:310-625-4406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW162711041C0700X
CA231571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical