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General NPI Number Information
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NPI Number | 1689584807
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Entity Type | Individual
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Provider Name | KATIE REYES
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Gender | Female
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Dates
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Enumeration Date | 09/09/2026
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Last Update Date | 09/09/2026
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Provider Practice Location Address
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Address Line | 200 MUIR RD
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City | MARTINEZ
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State | CA
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Zip | 94553-4672
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Country | US
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Telephone | 925-372-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 18303 KITTRIDGE ST APT 38
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City | RESEDA
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State | CA
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Zip | 91335-6162
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Country | US
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Telephone | 818-926-6172
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 22689
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License Number State | CA
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