Provider Demographics
NPI:1033000617
Name:GORDON REINOSO, JEANNETTE E (PHD)
Entity type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:E
Last Name:GORDON REINOSO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3295 N DRINKWATER BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6437
Mailing Address - Country:US
Mailing Address - Phone:928-851-6432
Mailing Address - Fax:
Practice Address - Street 1:3295 N DRINKWATER BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6437
Practice Address - Country:US
Practice Address - Phone:928-851-6432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-006022103TC1900X
TX34856103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling