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NPI Code Detail

MEDICARE: MORGAN REYES

MEDICARE: MORGAN 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1316558612
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN REYES
Provider Business Mailing Address
First Line : 32565 GOLDEN LANTERN ST STE B180
Second Line :
City : DANA POINT
State : CA
Zip : 92629-3247
Country : US
Telephone Number : 714-552-1317
Fax Number :
Provider Business Practice Location Address
First Line : 32565 GOLDEN LANTERN ST STE B180
Second Line :
City : DANA POINT
State : CA
Zip : 92629-3247
Country : US
Telephone Number : 714-552-1317
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2020
Last Update Date : 08/11/2020

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Directions to “ MORGAN REYES ” Practice Location

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