Provider Demographics
NPI:1972174266
Name:RENFREE, RORI GAIL
Entity type:Individual
Prefix:
First Name:RORI
Middle Name:GAIL
Last Name:RENFREE
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 1:745 GREENVILLE WOLF CREEK RD # 38
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95947-9632
Mailing Address - Country:US
Mailing Address - Phone:530-375-0532
Mailing Address - Fax:
Practice Address - Street 1:270 COUNTY HOSPITAL RD STE 109
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:CA
Practice Address - Zip Code:95971-9173
Practice Address - Country:US
Practice Address - Phone:530-283-6307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA1972174266171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health