Provider Demographics
NPI:1912149386
Name:REYNA, MONICA ANGELA (CMT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:ANGELA
Last Name:REYNA
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33511 8TH ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-2308
Mailing Address - Country:US
Mailing Address - Phone:510-712-7326
Mailing Address - Fax:
Practice Address - Street 1:33511 8TH ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-2308
Practice Address - Country:US
Practice Address - Phone:510-712-7326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist