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General NPI Number Information
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NPI Number | 1912893488
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Entity Type | Individual
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Provider Name | LAURA ALICIA REATEGUI MS, APCC
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Gender | Female
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 1666 PRECISION PARK LN
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City | SAN YSIDRO
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State | CA
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Zip | 92173-1346
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Country | US
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Telephone | 619-662-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 4370 PALM AVE # D-352
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City | SAN DIEGO
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State | CA
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Zip | 92154-1760
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Country | US
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Telephone | 619-587-4686
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19578
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License Number State | CA
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