Renaissance Behavioral Medicine

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

RENAISSANCE BEHAVIORAL MEDICINE

Practice address

8500 Wilshire Blvd Ste 520
Beverly Hills, CA 90211-3111

Phone

(213) 262-0888

Fax

(855) 347-9258

NPI assigned

Apr 28, 2021

Last updated

Apr 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Etefia, MDNPI 1346437787

Title

Psychiatrist

Phone

(650) 206-8932

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Kehinde Etefia, M.D.

  • Psychiatry Physician
  • San Mateo, CA
  • NPI 1346437787
  NPD (past) Authorized official

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1750964722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 WILSHIRE BLVD STE 520",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113111",
            "telephone_number": "213-262-0888",
            "fax_number": "855-347-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 WILSHIRE BLVD STE 520",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113111",
            "telephone_number": "213-262-0888",
            "fax_number": "855-347-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE BEHAVIORAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "ETEFIA",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "650-206-8932",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheldon Reiss, M.D.
• Uzzi Reiss, MD
• Ronald S Reiter, PHD
• Jonathan Reitman, M.D.
• Rejuveneda Medical Group, Inc
• Renato Calabria MD, Inc
• Renee Z Rinaldi MD Inc
• Renew Physical Therapy Group PC
• Renova Specialty Care PC
• Reproductive Partners Medical Group Inc (RPMG Surgical Center)

• Psychiatry Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.