Active NPI
Reena Reyes Fortune, RN-BSN
- General Practice Registered Nurse
- Oakland, CA
National Provider Identifier
1629665369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- 828194
- Practice address
- 1411 E 31St St
Oakland, CA 94602-1018 - Phone
- (510) 266-1700
- NPI assigned
- Dec 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 828194 | CA | Primary |
Addresses
Primary practice location
1411 E 31St St
Oakland, CA 94602-1018
Mailing address
1411 E 31St St
Oakland, CA 94602-1018
Phone (510) 303-0546
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 828194 | CA | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1629665369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 E 31ST ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946021018",
"telephone_number": "510-303-0546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 E 31ST ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946021018",
"telephone_number": "510-266-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNE",
"first_name": "REENA",
"middle_name": "REYES",
"credential": "RN-BSN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-29",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "CA",
"license": "828194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.