Healthcare Provider Details

I. General information

NPI: 1225957699
Provider Name (Legal Business Name): RENEWED HORIZONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6080 CENTER DR STE 631
LOS ANGELES CA
90045-9209
US

IV. Provider business mailing address

10982 MARYGOLD WAY
CORONA CA
92883-3113
US

V. Phone/Fax

Practice location:
  • Phone: 322-519-8691
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: VERALYN KAMARA
Title or Position: DIRECTOR
Credential:
Phone: 323-519-8691