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ROBERTO AHUMADA REYES BA OF PSYCHOLOGY

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1477162352

Individual Registrant:
 ROBERTO  AHUMADA REYES BA OF PSYCHOLOGY
Gender: M
Not Sole Proprietor

Location and contact information for practice:
380 ENCINAL ST STE 200  SANTA CRUZ, CA 95060-2178 US
Tel: 831-469-1700  Fax: 831-425-1905

Contact information for business:
380 ENCINAL ST STE 200  SANTA CRUZ, CA 95060-2178 US
Tel: 831-469-1700  Fax: 831-425-1905

Registration Information:
NPI: 1477162352
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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