Healthcare Provider Details

I. General information

NPI: 1316775950
Provider Name (Legal Business Name): VERONICA C REYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47825 OASIS ST
INDIO CA
92201-6950
US

IV. Provider business mailing address

PO BOX 1234
THERMAL CA
92274-1234
US

V. Phone/Fax

Practice location:
  • Phone: 760-863-8455
  • Fax: 760-863-8587
Mailing address:
  • Phone: 760-777-5633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT155383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: