Healthcare Provider Details

I. General information

NPI: 1033026802
Provider Name (Legal Business Name): MARGARITA REYNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 INGLEWOOD AVE
REDONDO BEACH CA
90278-3934
US

IV. Provider business mailing address

228 E 108TH ST
LOS ANGELES CA
90061-2504
US

V. Phone/Fax

Practice location:
  • Phone: 310-379-5449
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: