Provider Demographics
NPI:1295952497
Name:BACAS, RENEE ANTOINETTE (MD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:ANTOINETTE
Last Name:BACAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2719 N AIR FRESNO DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1547
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2719 N AIR FRESNO DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1547
Practice Address - Country:US
Practice Address - Phone:678-690-7757
Practice Address - Fax:404-751-5170
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG768692084P0804X
NMMD2021-76392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry