Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marlon Roa Reyes, MSNPMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1134861123

Marlon Roa Reyes, MSNPMHNP-BC is a Nurse Practitioner in Gardena, California. Qualified in 2021, 5 years ago. Practices with Ehab Yacoub MD Inc, a 175-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California, Florida and Nevada.

Years since qualifying
5
Licensed in
CA, FL, NV
In the registry since
2022
Specialties on file
3
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Practice location Address checks out

1225 W 190th St Ste 280
Gardena, CA 90248-4305
Phone: (310) 515-8113
Fax: (310) 538-2102
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95020637 (CA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 11019279 (FL)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 852172 (NV)

Record details

NPI number1134861123
Entity typeIndividual (Type 1)
GenderMale
Credentials MSNPMHNP-BC
Sole proprietorYes
NPI enumeratedApril 11, 2022
Last updated in NPPESJune 2, 2023
Certification dateJune 2, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ehab Yacoub Md Inc — 175 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Gardena