Healthcare Provider Details

I. General information

NPI: 1689578262
Provider Name (Legal Business Name): RENEN AMIR PHD, AMFT, P-RDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3731 FOLSOM ST
SAN FRANCISCO CA
94110-5653
US

IV. Provider business mailing address

3731 FOLSOM ST
SAN FRANCISCO CA
94110-5653
US

V. Phone/Fax

Practice location:
  • Phone: 415-699-0954
  • Fax:
Mailing address:
  • Phone: 415-699-0954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163453
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: