| Doctor Name: | LIESL CORRIN RENFREE |
| NPI Number: | 1265675714 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN747551 |
| Business Practice Address: | 10877 Conductor Blvd Ste 300 Sutter Creek, CA - 956859688 |
| Business Phone Number: | 2092236412 |
| Business Fax Number: | 2092230920 |
| Mailing Address: | 10877 Conductor Blvd Ste 300, SUTTER CREEK |
| State: | CA |
| Postal Code: | 956859688 |
| Phone Number: | 2092236412 |
| Fax Number: | 2092230920 |
| NPI Enumeration Date: | 04/14/2009 |
| NPI Last Update Date: | 04/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | RN747551 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |