Healthcare Provider Details

I. General information

NPI: 1780283168
Provider Name (Legal Business Name): BRENDA RIENRU RHIMA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRENDA RIENRU BIRHIRAY

II. Dates (important events)

Enumeration Date: 10/18/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2760 FASHION DR UNIT 205
CORONA CA
92883-5685
US

IV. Provider business mailing address

2760 FASHION DR UNIT 205
CORONA CA
92883-5685
US

V. Phone/Fax

Practice location:
  • Phone: 713-575-7724
  • Fax:
Mailing address:
  • Phone: 713-575-7724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95012344
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP137654
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95012344
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95012344
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number95012344
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: