Healthcare Provider Details

I. General information

NPI: 1154181840
Provider Name (Legal Business Name): STEVEN DANIEL REINHART-ODGERS RADT R1425850421
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ASH REINHART-ODGERS

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16400 LARK AVE STE 240
LOS GATOS CA
95032-2564
US

IV. Provider business mailing address

16400 LARK AVE STE 240
LOS GATOS CA
95032-2564
US

V. Phone/Fax

Practice location:
  • Phone: 650-770-7831
  • Fax:
Mailing address:
  • Phone: 650-770-7831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: