Provider Demographics
NPI:1023236346
Name:REYES, M. ANN (MSW)
Entity type:Individual
Prefix:
First Name:M. ANN
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2784 KELLOGG LOOP
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-7357
Mailing Address - Country:US
Mailing Address - Phone:925-243-1385
Mailing Address - Fax:925-243-0127
Practice Address - Street 1:1111 E STANLEY BLVD # D
Practice Address - Street 2:STE 112
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4115
Practice Address - Country:US
Practice Address - Phone:925-243-1385
Practice Address - Fax:925-243-0127
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker