MEDICARE: RAMONA REYES SEPULVEDA ASSOCIATE MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	137869	CA

General Provider Information

NPI Number	:	1063189454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMONA REYES SEPULVEDA ASSOCIATE MFT

Provider Business Mailing Address
First Line	:	301 THE CITY DR S FL 2
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-3205
Country	:	US
Telephone Number	:	714-935-6363
Fax Number	:	714-935-8112

Provider Business Practice Location Address
First Line	:	301 THE CITY DR S FL 2
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-3205
Country	:	US
Telephone Number	:	714-935-6363
Fax Number	:	714-935-8112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2021
Last Update Date	:	06/02/2026

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