Provider Demographics
NPI:1740739705
Name:ORTIZ-CROUCH, RENEE MICHELE
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:MICHELE
Last Name:ORTIZ-CROUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:MICHELE
Other - Last Name:CROUCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:7850 WHITE LN # E249
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7698
Mailing Address - Country:US
Mailing Address - Phone:661-834-7564
Mailing Address - Fax:661-831-8882
Practice Address - Street 1:7201 SCHIRRA CT STE E
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2051
Practice Address - Country:US
Practice Address - Phone:661-834-7564
Practice Address - Fax:661-831-8882
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-30
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95567106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist