Healthcare Provider Details

I. General information

NPI: 1790037661
Provider Name (Legal Business Name): MELANIE REYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 N. RAYMOND AVE. BLDG. 2-7
PASADENA CA
91103-9110
US

IV. Provider business mailing address

1515 W MISSION RD
ALHAMBRA CA
91803-1618
US

V. Phone/Fax

Practice location:
  • Phone: 626-396-5920
  • Fax:
Mailing address:
  • Phone: 626-943-3410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: