Provider Demographics
NPI:1215725759
Name:DELOS REYES, ANGELIKA
Entity type:Individual
Prefix:
First Name:ANGELIKA
Middle Name:
Last Name:DELOS REYES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6729 LAIRD AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2133
Mailing Address - Country:US
Mailing Address - Phone:510-813-0425
Mailing Address - Fax:
Practice Address - Street 1:6729 LAIRD AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2133
Practice Address - Country:US
Practice Address - Phone:510-813-0425
Practice Address - Fax:510-813-0425
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80111225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist