Provider Demographics
NPI:1285248161
Name:REYES-MOLINA, FERNANDA
Entity type:Individual
Prefix:
First Name:FERNANDA
Middle Name:
Last Name:REYES-MOLINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEJANDRA
Other - Middle Name:
Other - Last Name:REYES-MOLINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:775 FLEISCHMANN WAY
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-2995
Mailing Address - Country:US
Mailing Address - Phone:775-445-7773
Mailing Address - Fax:775-445-7331
Practice Address - Street 1:775 FLEISCHMANN WAY
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-2995
Practice Address - Country:US
Practice Address - Phone:775-445-7773
Practice Address - Fax:775-445-7331
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV171M00000X
NVCI5246101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator