Healthcare Provider Details

I. General information

NPI: 1508902214
Provider Name (Legal Business Name): RENEE JOANN SANGUINETTI MA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 FALCON DR
WEST LINN OR
97068-4189
US

IV. Provider business mailing address

3 MONROE PKWY STE P
LAKE OSWEGO OR
97035-8899
US

V. Phone/Fax

Practice location:
  • Phone: 408-375-9027
  • Fax:
Mailing address:
  • Phone: 696-232-3725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number43643 LMFT
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT2316
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: