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NPI Code Detail

MEDICARE: LELA MARIE REYES

MEDICARE: LELA MARIE REYES
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1174381578
Entity Type Code : Individual
Provider Name (Legal Business Name) : LELA MARIE REYES
Provider Business Mailing Address
First Line : 1315 D ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95814-0986
Country : US
Telephone Number : 805-550-6677
Fax Number :
Provider Business Practice Location Address
First Line : 2368 MARITIME DR STE 260
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-3654
Country : US
Telephone Number : 916-676-0488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2024
Last Update Date : 03/11/2024

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Directions to “ LELA MARIE REYES ” Practice Location

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