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NPI Code Detail

MEDICARE: DANIEL ERNESTO REZA

MEDICARE: DANIEL ERNESTO REZA
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
1101YP2500XProfessional Counselor11854CA

General Provider Information

NPI Number : 1093341257
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL ERNESTO REZA
Provider Business Mailing Address
First Line : 11358 HICKORY LN
Second Line :
City : POMONA
State : CA
Zip : 91766-4675
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 31200 VIA COLINAS STE 202
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91362-3955
Country : US
Telephone Number : 661-299-7022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2020
Last Update Date : 06/21/2024

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Directions to “ DANIEL ERNESTO REZA ” Practice Location

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