MEDICARE: STEPHANIE G 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
1	101YM0800X	Mental Health Counselor	78716	CA

General Provider Information

NPI Number	:	1255755401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE G REYES

Provider Business Mailing Address
First Line	:	9829 BLUE LARKSPUR LN STE 2
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-6535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9829 BLUE LARKSPUR LN STE 2
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-6535
Country	:	US
Telephone Number	:	831-647-8490
Fax Number	:

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

Provider Enumeration Date	:	02/07/2014
Last Update Date	:	06/12/2024

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Directions to “ STEPHANIE G REYES ” Practice Location

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