Healthcare Provider Details

I. General information

NPI: 1598493280
Provider Name (Legal Business Name): MRS. HEAVEN REY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7313 WHITTIER AVE
WHITTIER CA
90602-1132
US

IV. Provider business mailing address

401 N BEDFORD ST APT F
LA HABRA CA
90631-4809
US

V. Phone/Fax

Practice location:
  • Phone: 424-442-9129
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: