Individual
MR. JUSTICE RENAISSANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHRS
Contact information
Practice address
232 E GISH RD, SAN JOSE, CA 95112-4706
(408) 379-3790
Mailing address
251 LLEWELLYN AVE, CAMPBELL, CA 95008-1940
(408) 379-3790
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COUNTY ID
3497
CA
Enumeration date
11/15/2006
Last updated
04/27/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us