Individual
DIANE REYNAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAADE
Contact information
Practice address
44443 10TH ST W, LANCASTER, CA 93534-3346
(661) 726-2630
Mailing address
44443 10TH ST W, LANCASTER, CA 93534-3346
(661) 726-2630
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
071395
CA
Other
Enumeration date
07/02/2009
Last updated
07/06/2009
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