Provider Demographics
NPI:1295952562
Name:KREISS, JOSHUA (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:KREISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:645 N ARLINGTON AVE
Mailing Address - Street 2:STE 655
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4460
Mailing Address - Country:US
Mailing Address - Phone:775-770-6456
Mailing Address - Fax:775-770-6455
Practice Address - Street 1:645 N ARLINGTON AVE
Practice Address - Street 2:STE 655
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4460
Practice Address - Country:US
Practice Address - Phone:775-770-6456
Practice Address - Fax:775-770-6455
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1081802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1295952562Medicaid
NV15378OtherSTATE LICENSE
NV1295952562Medicaid