Individual
RENA EILEEN POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2945 MCMILLAN AVE STE 240, SAN LUIS OBISPO, CA 93401-6771
(805) 439-4890
(805) 439-4891
Mailing address
2945 MCMILLAN AVE STE 240, SAN LUIS OBISPO, CA 93401-6771
(805) 439-4890
(805) 439-4891
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT40735
CA
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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