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NPI Code Detail

MEDICARE: DR. ANNIE CLAIRE REN PSY.D.

MEDICARE: DR. ANNIE CLAIRE REN PSY.D.
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
1103TC0700XClinical Psychologist0005580CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PSY.0005580OTHERCOSTATE BOARD OF PSYCHOLOGIST EXAMINERS

General Provider Information

NPI Number : 1528722634
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANNIE CLAIRE REN PSY.D.
Provider Business Mailing Address
First Line : 4520 CENTENNIAL BLVD # 1109
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-3335
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 382 COCONUT CIR
Second Line :
City : WESTON
State : FL
Zip : 33326-3317
Country : US
Telephone Number : 954-366-9978
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2021
Last Update Date : 08/27/2025

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