MEDICARE: AINSLEY P REYNOLDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	LCSW137960	CA

General Provider Information

NPI Number	:	1043948136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AINSLEY P REYNOLDS

Provider Business Mailing Address
First Line	:	2655 30TH ST APT 101
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-3028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12021 WILMINGTON AVE STE 300
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90059-3019
Country	:	US
Telephone Number	:	424-454-6042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2022
Last Update Date	:	04/21/2026

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Directions to “ AINSLEY P REYNOLDS ” Practice Location

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