Healthcare Provider Details

I. General information

NPI: 1396497681
Provider Name (Legal Business Name): MALIA REYNOLDS MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

766 E COLORADO BLVD STE 108
PASADENA CA
91101-5421
US

IV. Provider business mailing address

766 E COLORADO BLVD STE 108
PASADENA CA
91101-5421
US

V. Phone/Fax

Practice location:
  • Phone: 213-340-4854
  • Fax:
Mailing address:
  • Phone: 213-340-4854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163164
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: