MEDICARE: NUTTALYA REUSSI

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
1	1041C0700X	Clinical Social Worker
2	171R00000X	Interpreter

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	5874	OTHER	HEALTH PARTNERS
2	568946544	OTHER	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932040664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NUTTALYA REUSSI

Provider Business Mailing Address
First Line	:	1268 SYNERGY
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92614-0159
Country	:	US
Telephone Number	:	949-903-8815
Fax Number	:

Provider Business Practice Location Address
First Line	:	1268 SYNERGY
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92614-0159
Country	:	US
Telephone Number	:	949-903-8815
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “ NUTTALYA REUSSI ” Practice Location

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