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General NPI Number Information
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NPI Number | 1952970956
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Entity Type | Individual
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Provider Name | MARITZA REYES
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Gender | Female
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 5931 TROTH ST
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City | JURUPA VALLEY
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State | CA
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Zip | 91752-2212
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Country | US
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Telephone | 619-929-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 9921 CARMEL MOUNTAIN RD # 368
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City | SAN DIEGO
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State | CA
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Zip | 92129-2813
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Country | US
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Telephone | 619-929-9050
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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