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General NPI Number Information
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NPI Number | 1245972199
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Entity Type | Individual
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Provider Name | REYNA IRACEMI RIOS LUIS NONE
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Gender | Female
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 701 W KIMBERLY AVE STE 102
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City | PLACENTIA
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State | CA
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Zip | 92870-6342
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Country | US
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Telephone | 714-966-8666
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Fax |
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Provider Business Mailing Address
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Address Line | 25910 ACERO STE 160
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City | MISSION VIEJO
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State | CA
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Zip | 92691-2777
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Country | US
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Telephone | 877-527-7227
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Fax | 714-428-3102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State | CA
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