Healthcare Provider Details

I. General information

NPI: 1730898909
Provider Name (Legal Business Name): CHRISTOPHER JOSEPH REINOSO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N HILL AVE STE 100
PASADENA CA
91106-1949
US

IV. Provider business mailing address

1312 STRATFORD AVE
SOUTH PASADENA CA
91030-3943
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-1111
  • Fax:
Mailing address:
  • Phone: 626-714-9920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: