Provider Demographics
NPI:1780057570
Name:SCHUSTER-WEISS, RENEE J (MA)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:J
Last Name:SCHUSTER-WEISS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:RENEE
Other - Middle Name:J
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:6909 MINSTREL AVENUE
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307
Mailing Address - Country:US
Mailing Address - Phone:818-340-7220
Mailing Address - Fax:818-340-7220
Practice Address - Street 1:6909 MINSTREL AVE
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307
Practice Address - Country:US
Practice Address - Phone:818-340-7220
Practice Address - Fax:818-340-7220
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF70757106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA954778897OtherMEDICARE
CA954778897Medicaid
CA954778897OtherMEDICAL