Provider Demographics
NPI:1699359059
Name:BARDINI, RENEE (MS)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:BARDINI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 NORTH FRESNO STREET
Mailing Address - Street 2:SUITE 370
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 NORTH FRESNO STREET
Practice Address - Street 2:SUITE 370
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701
Practice Address - Country:US
Practice Address - Phone:916-337-2998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS