Healthcare Provider Details

I. General information

NPI: 1255197000
Provider Name (Legal Business Name): ZHONGWEI REN LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14305 MORGAN ST
BALDWIN PARK CA
91706-3235
US

IV. Provider business mailing address

14305 MORGAN ST
BALDWIN PARK CA
91706-3235
US

V. Phone/Fax

Practice location:
  • Phone: 626-430-6197
  • Fax:
Mailing address:
  • Phone: 626-430-6197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT162694
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: