Individual
JILL E RENFRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
361 TOWN CTR W STE 101, SANTA MARIA, CA 93458-5076
(805) 922-6581
Mailing address
PO BOX 3581, PINEDALE, CA 93650-3581
(559) 436-0871
(559) 436-5221
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
569240
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
NA2675
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051861
CRNA ID
CA
01
—
569240
CA RN LICENSE
CA
Enumeration date
08/05/2006
Last updated
11/14/2022
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