Renewal Dermatology and Laser, Apmc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G75315 Issued in CA

Legal business name

RENEWAL DERMATOLOGY AND LASER, APMC

Practice address

10870 Brockway Rd
Truckee, CA 96161-2054

Phone

(530) 550-0440

Fax

(530) 582-8853

NPI assigned

Sep 14, 2007

Organization subpart

No

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

Authorized official

Name

Dianne C Kamenetsky, M.D.

Title

Owner

Phone

(530) 550-0440

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356480000000",
    "number": "1619163409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34120",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895334120",
            "telephone_number": "775-747-5050",
            "fax_number": "775-329-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10870 BROCKWAY RD",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961612054",
            "telephone_number": "530-550-0440",
            "fax_number": "530-582-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWAL DERMATOLOGY AND LASER, APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2012-12-26",
        "status": "A",
        "authorized_official_last_name": "KAMENETSKY",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-550-0440",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G75315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mileydi Ramirez, MSW, ACSW
• Phillip K Ravinale, DC
• Sarah Louise Yeo Redgrave, LCSW
• Alaina Shapiro Reichwald, LMFT
• Donald Reid
• Resonate Individual and Family Therapy
• Armando Raul Reyes Yparraguirre, MD
• Madeline Elizabeth Reyes, CD(DONA)
• Tanya Reynoso, LCSW
• Kari Jordan Rezac, DO

• Dermatology Physician in Truckee, CA
• Providers in Truckee, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.