Provider Demographics
NPI:1215784541
Name:REYES, HECTOR (PPS)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:REYES
Suffix:
Gender:M
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 C ST
Mailing Address - Street 2:
Mailing Address - City:GALT
Mailing Address - State:CA
Mailing Address - Zip Code:95632-2090
Mailing Address - Country:US
Mailing Address - Phone:209-745-1564
Mailing Address - Fax:
Practice Address - Street 1:21 C ST
Practice Address - Street 2:
Practice Address - City:GALT
Practice Address - State:CA
Practice Address - Zip Code:95632-2090
Practice Address - Country:US
Practice Address - Phone:209-745-1564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool