Provider Demographics
NPI:1063151819
Name:REN, CHRISTINA (MS, CGC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:REN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 TRINIDAD LN
Mailing Address - Street 2:
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-3724
Mailing Address - Country:US
Mailing Address - Phone:925-389-8523
Mailing Address - Fax:
Practice Address - Street 1:541 TRINIDAD LN
Practice Address - Street 2:
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-3724
Practice Address - Country:US
Practice Address - Phone:925-389-8523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC001277170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS