Provider Demographics
NPI:1104545409
Name:RAZO, RENEE IRENE
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:IRENE
Last Name:RAZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10024 BEN HUR AVE APT B
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-3170
Mailing Address - Country:US
Mailing Address - Phone:562-284-3741
Mailing Address - Fax:
Practice Address - Street 1:16314 CORNUTA AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-4814
Practice Address - Country:US
Practice Address - Phone:562-461-9272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)