Doctor Name: | MS. JESSICA MARI RENTZ |
NPI Number: | 1194025403 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 233 Baseline Rd Box 400 La Verne, CA - 917502353 |
Business Phone Number: | 9095932581 |
Business Fax Number: | |
Mailing Address: | 233 W. Baseline Rd., LAVERNE |
State: | CA |
Postal Code: | 917503129 |
Phone Number: | 9098332986 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2010 |
NPI Last Update Date: | 05/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |