Active NPI
Cristina Desiree Reyes, LM
- Midwife
- San Diego, CA
National Provider Identifier
1508438755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 651
- Practice address
- 4545 Fanuel St
San Diego, CA 92109-2904 - Phone
- (858) 900-2004
- NPI assigned
- Jul 15, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 651 | CA | Primary |
Addresses
Primary practice location
4545 Fanuel St
San Diego, CA 92109-2904
Mailing address
1664 Foothill Dr
Vista, CA 92084-4710
Phone (760) 681-0917
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 651 | CA | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tourmaline Birth and Wellness Collective | Midwife | Current | Accepting new patients |
Locations
4545 Fanuel St
San Diego, CA 92109
Phone (858) 200-6462
Organizations & group practices 1
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.
-
- Midwife
- San Diego, CA
- NPI 1043859168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626307200000",
"number": "1508438755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1664 FOOTHILL DR",
"city": "VISTA",
"state": "CA",
"postal_code": "920844710",
"telephone_number": "760-681-0917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4545 FANUEL ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921092904",
"telephone_number": "858-900-2004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "CRISTINA",
"middle_name": "DESIREE",
"credential": "LM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-15",
"last_updated": "2021-07-15",
"certification_date": "2021-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "651",
"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 Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.