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NPI Code Detail

MEDICARE: REENAH HARRIS MA, AMFT, APCC

MEDICARE: REENAH HARRIS MA, AMFT, APCC
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
1101YM0800XMental Health Counselor14174CA
2106H00000XMarriage & Family Therapist140402CA

General Provider Information

NPI Number : 1962123091
Entity Type Code : Individual
Provider Name (Legal Business Name) : REENAH HARRIS MA, AMFT, APCC
Provider Business Mailing Address
First Line : 1382 BLUE OAKS BLVD STE 213
Second Line :
City : ROSEVILLE
State : CA
Zip : 95678-7052
Country : US
Telephone Number : 510-945-0026
Fax Number :
Provider Business Practice Location Address
First Line : 1382 BLUE OAKS BLVD STE 213
Second Line :
City : ROSEVILLE
State : CA
Zip : 95678-7052
Country : US
Telephone Number : 510-945-0026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2022
Last Update Date : 02/03/2026

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