Provider Demographics
NPI:1326353608
Name:PENTON, RENEE KAYHAN
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:KAYHAN
Last Name:PENTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:KAYHAN
Other - Last Name:ULRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAC, CADC III
Mailing Address - Street 1:251 POST ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-5021
Mailing Address - Country:US
Mailing Address - Phone:415-852-5300
Mailing Address - Fax:
Practice Address - Street 1:251 POST ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-5021
Practice Address - Country:US
Practice Address - Phone:415-852-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR09-09-68U101YA0400X
171M00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator