Destiny Susseht Reynoso

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2720 S Bristol St Ste 100
Santa Ana, CA 92704-6207

Phone

(714) 426-5123

NPI assigned

Sep 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1154042083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 S BRISTOL ST STE 200",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046207",
            "telephone_number": "714-426-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 S BRISTOL ST STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046207",
            "telephone_number": "714-426-5123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8041 Newman Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926477034",
            "country_code": "US",
            "telephone_number": "888-499-9309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 N Main St",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927012304",
            "country_code": "US",
            "telephone_number": "888-499-9303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1325 N Anaheim Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928011202",
            "country_code": "US",
            "telephone_number": "888-499-9309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4010 E Chapman Ave",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928693990",
            "country_code": "US",
            "telephone_number": "888-499-9309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOSO",
        "first_name": "DESTINY",
        "middle_name": "SUSSEHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306015425",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740427657",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760651814",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932756764",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316116221",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.altamed.org/?gclid=Cj0KCQjwpeaYBhDXARIsAEzItbHimZHl93pHI7iLPGAaOXSYmjAe8FXJkihqYK5TVo_LvIMp2EmT-pkaApdCEALw_wcB",
            "affiliation": "N",
            "endpointDescription": "https://www.altamed.org/?gclid=Cj0KCQjwpeaYBhDXARIsAEzItbHimZHl93pHI7iLPGAaOXSYmjAe8FXJkihqYK5TVo_LvIMp2EmT-pkaApdCEALw_wcB",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2720 S Bristol St Ste 100",
            "city": "Santa Ana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927046207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rudy Reyes
• Sandra Patricia Reyes, REGISTERED NURSE
• Melissa Reyna-Rodriguez
• Elanyn Sandra Reynaga
• Lauren Reynolds
• Joanna Reynoso
• Jocelyn Reynoso
• Laura Reynoso
• Reza Shafee MD Inc.
• Vickie Reza

• Case Manager/Care Coordinator in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.