Healthcare Provider Details

I. General information

NPI: 1326478769
Provider Name (Legal Business Name): DEL REY CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2013
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3974 PROSSER ST UNITED STATES, COMMONWEAL
WEST SACRAMENTO CA
95691-6215
US

IV. Provider business mailing address

3974 PROSSER ST UNITED STATES, COMMONWEAL
WEST SACRAMENTO CA
95691-6215
US

V. Phone/Fax

Practice location:
  • Phone: 916-596-5139
  • Fax:
Mailing address:
  • Phone: 916-596-5139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number69512
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number090111398
License Number StateCA

VIII. Authorized Official

Name: MR. JEFFREY REYES
Title or Position: CEO
Credential: MA
Phone: 916-617-2137