Provider Demographics
NPI:1669801841
Name:RENJITH, DHANYA (CRNA)
Entity type:Individual
Prefix:
First Name:DHANYA
Middle Name:
Last Name:RENJITH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DHANYA
Other - Middle Name:
Other - Last Name:DHARMARAJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 VALLEY VIEW RD
Mailing Address - Street 2:APT #123
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1751
Mailing Address - Country:US
Mailing Address - Phone:310-200-0075
Mailing Address - Fax:310-295-0065
Practice Address - Street 1:1401 VALLEY VIEW RD
Practice Address - Street 2:APT #123
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-1751
Practice Address - Country:US
Practice Address - Phone:310-200-0075
Practice Address - Fax:310-295-0065
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000017367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered