Provider Demographics
NPI:1780933457
Name:RENTERIA, JODEE QUIRK (MA)
Entity type:Individual
Prefix:MRS
First Name:JODEE
Middle Name:QUIRK
Last Name:RENTERIA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5771
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93005-0771
Mailing Address - Country:US
Mailing Address - Phone:805-701-7027
Mailing Address - Fax:805-620-0789
Practice Address - Street 1:2055 SAVIERS RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3608
Practice Address - Country:US
Practice Address - Phone:805-525-4699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)