MEDICARE: AILEEN REYES MORENO

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	106H00000X	Marriage & Family Therapist	1444170	CA

General Provider Information

NPI Number	:	1710615018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AILEEN REYES MORENO

Provider Business Mailing Address
First Line	:	3142 VISTA WAY STE 207
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-3628
Country	:	US
Telephone Number	:	760-248-4002
Fax Number	:

Provider Business Practice Location Address
First Line	:	3142 VISTA WAY STE 207
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-3628
Country	:	US
Telephone Number	:	760-248-4002
Fax Number	:

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

Provider Enumeration Date	:	08/13/2022
Last Update Date	:	03/02/2026

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Directions to “ AILEEN REYES MORENO ” Practice Location

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