Active NPI
Decie Jean Reyes, MA
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1467939751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 145508
- Practice address
- 480 Alta Rd
San Diego, CA 92179-0001 - Phone
- (619) 661-6500
- NPI assigned
- Jul 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | 145508 | CA | Primary |
Addresses
Primary practice location
480 Alta Rd
San Diego, CA 92179-0001
Mailing address
7733 Park Village Rd
San Diego, CA 92129-4547
Phone (858) 335-6252
Other practice location 1
2865 Logan Ave
San Diego, CA 92113-2411
Phone (619) 232-4357
Other practice location 2
9888 Carroll Centre Rd Ste 216
San Diego, CA 92126-4515
Phone (858) 413-7557
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 145508 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tracy Wutzke, Psy.D | Marriage & Family Therapist | Past | Accepting new patients |
| State of California Prison Industry Authority | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Eyewear Supplier
- San Diego, CA
- NPI 1356558001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1467939751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7733 PARK VILLAGE RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921294547",
"telephone_number": "858-335-6252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 ALTA RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921790001",
"telephone_number": "619-661-6500"
}
],
"practiceLocations": [
{
"address_1": "2865 Logan Ave",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921132411",
"country_code": "US",
"telephone_number": "619-232-4357",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9888 Carroll Centre Rd Ste 216",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921264515",
"country_code": "US",
"telephone_number": "858-413-7557",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REYES",
"first_name": "DECIE JEAN",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-19",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "145508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.