Individual
LIVAN REYNOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14632 YORBA ST STE B, TUSTIN, CA 92780-2554
(714) 714-0780
Mailing address
14632 YORBA ST STE B, TUSTIN, CA 92780-2554
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
CA
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
02/28/2026
Last updated
03/11/2026
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