Provider Demographics
NPI:1730481441
Name:WEST, RENEE (ND)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3271 CAMINITO AMECA
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-2902
Mailing Address - Country:US
Mailing Address - Phone:970-948-5102
Mailing Address - Fax:
Practice Address - Street 1:3271 CAMINITO AMECA
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-2902
Practice Address - Country:US
Practice Address - Phone:970-948-5102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1429202D00000X, 202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine