=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194664896
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | QUIN REUSS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2026
-----------------------------------------------------
Last Update Date | 03/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1221 PRESERVATION PARK WAY STE 203
-----------------------------------------------------
City | OAKLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94612-1277
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-224-3360
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 672 8TH ST APT A
-----------------------------------------------------
City | OAKLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94607-3654
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-224-3360
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246Z00000X
-----------------------------------------------------
Taxonomy Name | Other Specialist/Technologist
-----------------------------------------------------
License Number | L10122
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------