Healthcare Provider Details

I. General information

NPI: 1891659710
Provider Name (Legal Business Name): XIMENA REYNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 S ARIZONA AVE
YUMA AZ
85364-8537
US

IV. Provider business mailing address

2345 S ARIZONA AVE
YUMA AZ
85364-8537
US

V. Phone/Fax

Practice location:
  • Phone: 928-502-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: