Provider Demographics
NPI:1669013157
Name:RENTERIA, DENISE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RENTERIA
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 1:14534 HAYWARD ST
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-1844
Mailing Address - Country:US
Mailing Address - Phone:805-588-4078
Mailing Address - Fax:
Practice Address - Street 1:18 TECHNOLOGY DR STE 206
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2314
Practice Address - Country:US
Practice Address - Phone:949-540-9992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-05
Last Update Date:2019-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other