Stephanie Martinez Reynoso

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW82695 Issued in CA

Practice address

1160 S Grand Ave
Glendora, CA 91740

Phone

(626) 335-5980

NPI assigned

Sep 4, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1124453584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405000",
            "telephone_number": "626-335-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "91740",
            "telephone_number": "626-335-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOSO",
        "first_name": "STEPHANIE",
        "middle_name": "MARTINEZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW66697",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW82695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Rehfeld
• Glenda Lee Reid, LCSW
• David Michael Reyes, M.D.
• Honeyleen Reyes
• Jeanette Reyes
• Kurtis Rice
• Richard G Johnson MD Inc
• Richard L Forgey Lori L Matsuno Partnership
• Richard L. Forgey Lori L. Matsuno Partnership
• N Rowan Richards, D.C.

• Clinical Social Worker in Glendora, CA
• Providers in Glendora, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.