Provider Demographics
NPI:1154181840
Name:REINHART-ODGERS, STEVEN DANIEL (RADT R1425850421)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:DANIEL
Last Name:REINHART-ODGERS
Suffix:
Gender:M
Credentials:RADT R1425850421
Other - Prefix:
Other - First Name:ASH
Other - Middle Name:
Other - Last Name:REINHART-ODGERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16400 LARK AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2564
Mailing Address - Country:US
Mailing Address - Phone:650-770-7831
Mailing Address - Fax:
Practice Address - Street 1:16400 LARK AVE STE 240
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2564
Practice Address - Country:US
Practice Address - Phone:650-770-7831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)