Individual
TENNILLE RENEE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAS
Contact information
Practice address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 784-2057
(707) 427-2981
Mailing address
7000 LEISURE TOWN RD, VACAVILLE, CA 95688-9413
(707) 249-1062
(707) 453-0384
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
03-061421
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-061421
CAS
CA
Enumeration date
03/13/2007
Last updated
09/30/2025
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