Healthcare Provider Details

I. General information

NPI: 1194664896
Provider Name (Legal Business Name): QUIN REUSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 PRESERVATION PARK WAY STE 203
OAKLAND CA
94612-1277
US

IV. Provider business mailing address

672 8TH ST APT A
OAKLAND CA
94607-3654
US

V. Phone/Fax

Practice location:
  • Phone: 510-224-3360
  • Fax:
Mailing address:
  • Phone: 510-224-3360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License NumberL10122
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: