Provider Demographics
NPI:1407881865
Name:RENOUF, ANDREW G (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:G
Last Name:RENOUF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 HUBBARD LN
Mailing Address - Street 2:SUITE 6
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-4802
Mailing Address - Country:US
Mailing Address - Phone:707-269-7011
Mailing Address - Fax:707-444-2757
Practice Address - Street 1:3015 HUBBARD LN
Practice Address - Street 2:SUITE 6
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4802
Practice Address - Country:US
Practice Address - Phone:707-269-7011
Practice Address - Fax:707-444-2757
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15843103TC0700X, 103TC2200X, 103TF0200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist