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General NPI Number Information
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NPI Number | 1972169480
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Entity Type | Organization
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Legal Business Name | RENEW SCIENCE A PROFESSIONAL NURSING CORPORATION
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Dates
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Enumeration Date | 05/10/2019
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 1815 4TH ST
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City | SANTA ROSA
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State | CA
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Zip | 95404-3202
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Country | US
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Telephone | 707-828-8440
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 4TH ST
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City | SANTA ROSA
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State | CA
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Zip | 95404-3202
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Country | US
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Telephone | 707-828-8440
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Fax | 707-737-0224
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Authorized Official
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Title or Position | OWNER
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Name | NAYABEI BARRETTO
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Credential | NP
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Telephone | 707-799-6125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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