Healthcare Provider Details

I. General information

NPI: 1205359353
Provider Name (Legal Business Name): REASIA AUSTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3499 10TH ST
RIVERSIDE CA
92501-3617
US

IV. Provider business mailing address

600 N ARROWHEAD AVE
SAN BERNARDINO CA
92401-1164
US

V. Phone/Fax

Practice location:
  • Phone: 951-955-1560
  • Fax:
Mailing address:
  • Phone: 909-963-5355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: