Elisse Reyna

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

82176 Issued in CA

Practice address

2670 S White Rd Ste 170
San Jose, CA 95148-2071

Phone

(408) 755-3905

NPI assigned

Apr 2, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Elisse Cabrales Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1871099523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S WHITE RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 S WHITE RD STE 170",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482071",
            "telephone_number": "408-755-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNA",
        "first_name": "ELISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "82176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISSE",
            "last_name": "CABRALES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Selina Reyes
• Sergio Antonio Reyes
• Shirley Jacqueline Reyes
• Stephanie Lorraine Reyes
• Genesis Reyna Benitez
• Madison Reyna
• Agustin Reynaga Jr.
• C. June Reynolds, MD
• Eloisa Piri Reynolds
• Jennifer Mary Reynolds

• Clinical Social Worker in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.