Joan Mayre Renfroe, LVN, IP, DSD

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

708453 Issued in CA

Practice address

699 Winners Cir
San Jacinto, CA 92582-2741

Phone

(951) 487-3815

NPI assigned

Oct 16, 2020

Last updated

Oct 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1598363913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 SAINT MICHELE",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925835737",
            "telephone_number": "813-952-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 WINNERS CIR",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925822741",
            "telephone_number": "951-487-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENFROE",
        "first_name": "JOAN",
        "middle_name": "MAYRE",
        "name_prefix": "Mrs.",
        "credential": "LVN, IP, DSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5199749",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "708453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Vocational Nurse in San Jacinto, CA
• Providers in San Jacinto, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.