Provider Demographics
NPI:1932820784
Name:PAZIENZA, RENA LEON (PHD)
Entity Type:Individual
Prefix:DR
First Name:RENA
Middle Name:LEON
Last Name:PAZIENZA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 THICKETT RD
Mailing Address - Street 2:
Mailing Address - City:CASTLETON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12033-9674
Mailing Address - Country:US
Mailing Address - Phone:518-286-8001
Mailing Address - Fax:
Practice Address - Street 1:1900 NE 3RD ST STE 106-1019
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3894
Practice Address - Country:US
Practice Address - Phone:541-382-8600
Practice Address - Fax:775-297-8856
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39175103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling