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NPI Code Detail

MEDICARE: MS. AMARILYS REYES LMFT

MEDICARE: MS. AMARILYS REYES LMFT
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
1106H00000XMarriage & Family TherapistLMFT97788CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
197788OTHERCAMFT LICENSE
275571OTHERCALICENSE

General Provider Information

NPI Number : 1720429400
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMARILYS REYES LMFT
Provider Business Mailing Address
First Line : 10200 SEPULVEDA BLVD STE 170
Second Line :
City : MISSION HILLS
State : CA
Zip : 91345-3322
Country : US
Telephone Number : 661-916-1733
Fax Number :
Provider Business Practice Location Address
First Line : 10200 SEPULVEDA BLVD STE 170
Second Line :
City : MISSION HILLS
State : CA
Zip : 91345-3322
Country : US
Telephone Number : 661-916-1733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2013
Last Update Date : 12/17/2021

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