Individual
DR. JOHN DERENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MERCY CIRCLE, CAMP PENDLETON, CA 92055-5191
(760) 725-1288
Mailing address
PO BOX 555191, CAMP PENDLETON, CA 92055-5191
(760) 763-1639
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101252411
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2011
Last updated
05/13/2024
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