| Carolina Reyes, | |
|
11201 Benton St, Loma Linda, CA 92357-1000 | |
| (909) 825-7084 | |
| (909) 777-3884 |
| Full Name | Carolina Reyes |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 11201 Benton St, Loma Linda, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417464009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 88151 (California) | Primary |
| 1041C0700X | Social Worker - Clinical | .12277 (South Carolina) | Secondary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Reyes, 11201 Benton St, Loma Linda, CA 92357-1000 Ph: () - | Carolina Reyes, 11201 Benton St, Loma Linda, CA 92357-1000 Ph: (909) 825-7084 |
Jungmi Lee, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11201 Benton St, Loma Linda, CA 92357 Phone: 909-825-7084 | |
Raychelle Harper Addo, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11201 Benton St, Loma Linda, Loma Linda, CA 92357 Phone: 951-398-8410 | |
Maria Ormonde, DPA, LCSW, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Po Box 973, Loma Linda, CA 92354 Phone: 951-552-8018 | |
Sunghay Grace Cho, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11201 Benton St, Loma Linda, CA 92357 Phone: 909-825-7084 | |
Chiana Ghant, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11201 Benton St, Loma Linda, CA 92357 Phone: 909-825-7084 | |
Andrew Alexander Montes, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11201 Benton St, Loma Linda, CA 92357 Phone: 909-825-7084 | |
Phillip Parra, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 11201 Benton St., Social Work Department, Loma Linda, CA 92357 Phone: 909-825-7084 |