Jennifer Renzas

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95016776 Issued in CA

Practice address

4060 Fairmount Ave
San Diego, CA 92105-1608

Phone

(619) 255-9155

NPI assigned

Sep 20, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jennifer.renzas.p1@direct.lamaestra.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• La Maestra Family Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • El Cajon, CA
  • NPI 1306929443
  Medicare reassignment NPD
• La Maestra Family Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • El Cajon, CA
  • NPI 1134590086
  NPD
• La Maestra Family Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • El Cajon, CA
  • NPI 1568209773
  NPD
• La Maestra Family Clinic

  • Federally Qualified Health Center (FQHC)
  • National City, CA
  • NPI 1336324904
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1225512759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051608",
            "telephone_number": "619-255-9155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6300 N California Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606591702",
            "country_code": "US",
            "telephone_number": "312-858-0474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENZAS",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018207",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95016776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Renteria
• Perla Renteria
• Roxana Renteria
• Xochitl Renteria
• Sherena Rentschler, MS, CCC-SLP
• Mary Ann Renzi, MD
• Mrudula Chamakura Repaka, DDS
• Nicole Reppucci, LPCC
• Reproductive Medicine Associates of San Diego
• Reproductive Mental Health and Wellness Licensed Clinical Social Worke

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.