Healthcare Provider Details

I. General information

NPI: 1124555669
Provider Name (Legal Business Name): MRS. RENEE LYNNETTE KATZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 COMPTON AVE
LOS ANGELES CA
90002-3628
US

IV. Provider business mailing address

10300 COMPTON AVE
LOS ANGELES CA
90002-3628
US

V. Phone/Fax

Practice location:
  • Phone: 323-564-4331
  • Fax: 323-564-9864
Mailing address:
  • Phone: 323-564-4331
  • Fax: 323-564-9864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN493909
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: