Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. EUGENIO FAJARDO REYES
Active Sole ProprietorICF/Individuals with Intellectual Disabilities · LODI, CA
Registration Details
- NPI Number
- 1619132198
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 23, 2008 (17.74747246901 yrs)
- Last Updated
- Jul 23, 2008
- License
-
PENDING (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3261 W SARGENT RDLODI, CA, 952429212Browse CA providers · Browse ZIP 95242
- Phone
- 9259637957
- Fax
- 2093697010
- Primary Specialty
-
ICF/Individuals with Intellectual Disabilities
315P00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.