Healthcare Provider Details

I. General information

NPI: 1831495738
Provider Name (Legal Business Name): RENNA R RHEA L.AC. , R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2011
Last Update Date: 02/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 S CHESTER AVE 100
PASADENA CA
91106-5804
US

IV. Provider business mailing address

3731 S CANFIELD AVE #1
LOS ANGELES CA
90034-4138
US

V. Phone/Fax

Practice location:
  • Phone: 626-356-3220
  • Fax:
Mailing address:
  • Phone: 310-836-8858
  • Fax: 310-836-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN359391
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC7694
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: