Provider Demographics
NPI:1275770661
Name:POZZA, RENEE SUE (PHD, RN, FNP-BC, CNS)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:SUE
Last Name:POZZA
Suffix:
Gender:F
Credentials:PHD, RN, FNP-BC, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 CAMINO DE LOS MARES
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-2835
Mailing Address - Country:US
Mailing Address - Phone:949-496-6002
Mailing Address - Fax:949-496-6004
Practice Address - Street 1:675 CAMINO DE LOS MARES
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2835
Practice Address - Country:US
Practice Address - Phone:949-496-6002
Practice Address - Fax:949-496-6004
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445034163W00000X
CA12319363LF0000X
CA90364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health