Provider Demographics
NPI:1588987994
Name:VEURINK, REGINALD LEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:REGINALD
Middle Name:LEE
Last Name:VEURINK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21851 OLIVA CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3966
Mailing Address - Country:US
Mailing Address - Phone:661-297-5728
Mailing Address - Fax:661-296-3682
Practice Address - Street 1:26889 BOUQUET CANYON RD
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2372
Practice Address - Country:US
Practice Address - Phone:661-297-5728
Practice Address - Fax:661-296-3682
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14007103T00000X
CAMFC14374106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist