Kelly Reyes, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

109304 Issued in CA

Practice address

4000 W Metropolitan Dr Ste 402
Orange, CA 92868-3504

Phone

(714) 954-2900

NPI assigned

Nov 30, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 25, 2024 through Jan 25, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• County of Orange

  • Adolescent and Children Mental Health Clinic/Center
  • Orange, CA
  • NPI 1598389371
  NPD

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1972073104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 402",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-954-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 402",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-954-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "KELLY",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "109304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Reyes
• Jordan Reyes
• Juliana Reyes
• Karen Reyes
• Karen Jeannette Reyes
• Keyleen Reyes
• Lizette Reyes
• Melanie Reyes
• Nancy Reyes
• Pablo Reyes

• Marriage & Family Therapist in Orange, CA
• Providers in Orange, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.