Healthcare Provider Details

I. General information

NPI: 1528982824
Provider Name (Legal Business Name): CHRISTINE REYES
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CALLE AMANECER
SAN CLEMENTE CA
92673-6214
US

IV. Provider business mailing address

1000 CALLE AMANECER
SAN CLEMENTE CA
92673-6214
US

V. Phone/Fax

Practice location:
  • Phone: 949-498-5100
  • Fax:
Mailing address:
  • Phone: 949-498-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: