Provider Demographics
NPI:1093097644
Name:LOBO, RENEE MARIE
Entity Type:Individual
Prefix:MISS
First Name:RENEE
Middle Name:MARIE
Last Name:LOBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6833 STOCKTON BLVD
Mailing Address - Street 2:STE 485
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2372
Mailing Address - Country:US
Mailing Address - Phone:916-394-0800
Mailing Address - Fax:916-429-7824
Practice Address - Street 1:6833 STOCKTON BLVD
Practice Address - Street 2:STE 485
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-1820
Practice Address - Country:US
Practice Address - Phone:916-394-0800
Practice Address - Fax:916-429-7824
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator