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NPI Code Detail

MEDICARE: CECILIA A REUS MA

MEDICARE: CECILIA A REUS MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistIMF 46997CA
2106H00000XMarriage & Family Therapist47652CA

General Provider Information

NPI Number : 1225236342
Entity Type Code : Individual
Provider Name (Legal Business Name) : CECILIA A REUS MA
Provider Business Mailing Address
First Line : 747 52ND ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-1809
Country : US
Telephone Number : 510-428-3885
Fax Number : 510-238-9764
Provider Business Practice Location Address
First Line : 312 CLAY ST
Second Line :
City : OAKLAND
State : CA
Zip : 94607-3508
Country : US
Telephone Number : 510-428-3885
Fax Number : 510-238-9764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2007
Last Update Date : 06/12/2023

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Directions to “ CECILIA A REUS MA” Practice Location

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