Provider Demographics
NPI:1780552976
Name:REYES, DANIELA (DC)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1948 RAILROAD AVE UNIT 106
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-2123
Mailing Address - Country:US
Mailing Address - Phone:925-621-9542
Mailing Address - Fax:
Practice Address - Street 1:1101 S WINCHESTER BLVD STE M257
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3904
Practice Address - Country:US
Practice Address - Phone:408-502-6358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor