MEDICARE: MRS. RENEE JOANN SANGUINETTI MA LMFT

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
1	106H00000X	Marriage & Family Therapist	43643 LMFT	CA
2	106H00000X	Marriage & Family Therapist	T2316	OR

General Provider Information

NPI Number	:	1508902214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RENEE JOANN SANGUINETTI MA LMFT

Provider Business Mailing Address
First Line	:	3 MONROE PKWY STE P
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-8899
Country	:	US
Telephone Number	:	696-232-3725
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 FALCON DR
Second Line	:
City	:	WEST LINN
State	:	OR
Zip	:	97068-4189
Country	:	US
Telephone Number	:	408-375-9027
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	10/23/2023

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