Provider Demographics
NPI:1518476928
Name:EUWING, RENNIE ROSHELL
Entity Type:Individual
Prefix:
First Name:RENNIE
Middle Name:ROSHELL
Last Name:EUWING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 E NORBERRY ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-6169
Mailing Address - Country:US
Mailing Address - Phone:661-575-3473
Mailing Address - Fax:
Practice Address - Street 1:45043 SIERRA HWY # A
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2519
Practice Address - Country:US
Practice Address - Phone:661-726-3337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner