Renova San Diego

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

RENOVA SAN DIEGO

Practice address

12396 World Trade Dr Ste 109
San Diego, CA 92128-3787

Phone

(619) 895-0509

NPI assigned

Aug 11, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Marchita Masters, PSY.D.

Title

Director of Clinical Psych Program

Phone

(858) 722-4372

Specialties & licenses 2

Addresses

Other names 1

• DR BEN INOUYE AND DR LISA J PALMER FOUNDATION FOR FAMILY Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Jeanne Palmer-Olsen, MFT

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1417093345
  NPD (past)

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1285362772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12396 WORLD TRADE DR STE 109",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283787",
            "telephone_number": "858-722-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12396 WORLD TRADE DR STE 109",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283787",
            "telephone_number": "619-895-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENOVA SAN DIEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-11",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "MASTERS",
        "authorized_official_first_name": "MARCHITA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL PSYCH PROGRAM",
        "authorized_official_telephone_number": "858-722-4372",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR BEN INOUYE AND DR LISA J PALMER FOUNDATION FOR FAMILY",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Shawn Renner, PT
• Laurie Rennie, LCSW
• Levi James Renninger, PT, DPT
• Kimberly Marie Reno, PA-C
• Theresa Reno
• David Rens, DDS
• Karen Rens, DC
• Noel Joy Rensch
• Katherine Rensink, FNP
• Scott David Renslow, M.D.

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.