Provider Demographics
NPI:1144643040
Name:REYES, GINA
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7850 VANCE DR STE 185
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2127
Mailing Address - Country:US
Mailing Address - Phone:808-494-5507
Mailing Address - Fax:
Practice Address - Street 1:7850 VANCE DR STE 185
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2127
Practice Address - Country:US
Practice Address - Phone:808-494-5507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27982103TC0700X
HI1589103TC0700X
AZPSY-005244103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty