MEDICARE: MARLIN REYES

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	101YP2500X	Professional Counselor	21152	CA

General Provider Information

NPI Number	:	1063371581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLIN REYES

Provider Business Mailing Address
First Line	:	7570 CHURCH ST APT 6
Second Line	:
City	:	LEMON GROVE
State	:	CA
Zip	:	91945-2346
Country	:	US
Telephone Number	:	858-208-0121
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 BIRMINGHAM DR STE 240A
Second Line	:
City	:	CARDIFF
State	:	CA
Zip	:	92007-1757
Country	:	US
Telephone Number	:	858-208-0121
Fax Number	:

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ MARLIN REYES ” Practice Location

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