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General NPI Number Information
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NPI Number | 1629436449
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Entity Type | Individual
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Provider Name | FAITH JOLEEN REYES LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 334 VILLAGE LN
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City | LOS GATOS
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State | CA
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Zip | 95030-7218
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Country | US
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Telephone | 916-320-6552
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Fax |
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Provider Business Mailing Address
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Address Line | 468 N. CAMDEN DR STE 200 , # 96198
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-3225
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Country | US
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Telephone |
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 106204
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License Number State | CA
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