Healthcare Provider Details

I. General information

NPI: 1538595525
Provider Name (Legal Business Name): RENATA FIGUEIREDO SASSON PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 BROADWAY STE 204
PROVIDENCE RI
02909-1101
US

IV. Provider business mailing address

55 CROMWELL ST APT 306
PROVIDENCE RI
02907-2567
US

V. Phone/Fax

Practice location:
  • Phone: 401-484-0996
  • Fax: 401-648-4600
Mailing address:
  • Phone: 978-652-8423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN0996714-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN00501
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: