Provider Demographics
NPI:1831745181
Name:REYES, GABRIELA ANGELA
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:ANGELA
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 1:2002 N FINE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1511
Mailing Address - Country:US
Mailing Address - Phone:559-457-6975
Mailing Address - Fax:559-256-5732
Practice Address - Street 1:2002 N FINE AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1511
Practice Address - Country:US
Practice Address - Phone:559-457-6975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator