Provider Demographics
NPI:1376994251
Name:OWENS, RENEE YVONNE (WELLNESS COACH)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:YVONNE
Last Name:OWENS
Suffix:
Gender:F
Credentials:WELLNESS COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2523 EL PORTAL DR
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3305
Mailing Address - Country:US
Mailing Address - Phone:510-215-3774
Mailing Address - Fax:510-215-3770
Practice Address - Street 1:2523 EL PORTAL DR
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3305
Practice Address - Country:US
Practice Address - Phone:510-215-3774
Practice Address - Fax:510-215-3770
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker