Provider Demographics
NPI:1639447717
Name:REYES, TRINA MAGAT (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:TRINA
Middle Name:MAGAT
Last Name:REYES
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1156 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95064-0001
Mailing Address - Country:US
Mailing Address - Phone:831-459-2360
Mailing Address - Fax:831-459-3564
Practice Address - Street 1:1156 HIGH ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95064-0001
Practice Address - Country:US
Practice Address - Phone:831-459-2360
Practice Address - Fax:831-459-3564
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist