Provider Demographics
NPI:1477110864
Name:RENAUX, VALARIE CHRISTINE (RN, MSN, FNP)
Entity Type:Individual
Prefix:
First Name:VALARIE
Middle Name:CHRISTINE
Last Name:RENAUX
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 N VENTU PARK RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2718
Mailing Address - Country:US
Mailing Address - Phone:805-480-0499
Mailing Address - Fax:
Practice Address - Street 1:558 N VENTU PARK RD
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-2718
Practice Address - Country:US
Practice Address - Phone:805-480-0499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG19281174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1932365517OtherNPI