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NPI Code Detail

MEDICARE: MRS. CYNTHIA RENEE RENFROW

MEDICARE: MRS. CYNTHIA RENEE RENFROW
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
11041C0700XClinical Social Worker107661CA

General Provider Information

NPI Number : 1437705597
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CYNTHIA RENEE RENFROW
Provider Business Mailing Address
First Line : 1700 MCHENRY AVE STE 65B
Second Line :
City : MODESTO
State : CA
Zip : 95350-4333
Country : US
Telephone Number : 209-324-2730
Fax Number :
Provider Business Practice Location Address
First Line : 1225 OAKDALE RD
Second Line :
City : MODESTO
State : CA
Zip : 95355-3357
Country : US
Telephone Number : 209-557-6242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2019
Last Update Date : 03/13/2026

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