Individual provider Active NPI

Heather Ann Renz, NP RN CNM

  • Psychiatric/Mental Health Nurse Practitioner
  • San Rafael, CA
National Provider Identifier
1770695967
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
15767 Issued in CA
Practice address
3260 Kerner Blvd
San Rafael, CA 94901-4840
Phone
(415) 444-8150
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 622677 CA
Women's Health Nurse Practitioner 363LW0102X 15767 CA
Advanced Practice Midwife 367A00000X 1693 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 15767 CA Primary

Addresses

Primary practice location

3260 Kerner Blvd
San Rafael, CA 94901-4840

Mailing address

3260 Kerner Blvd
San Rafael, CA 94901-4840
Phone (415) 484-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
622677CAMDAmbulatory Women's Health Care Registered Nurse
1693CAMDMassage Therapist
15767CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents Univ of California UCSF CurrentSince Nov 15, 2018 Accepting new patients
LGTC Group Psychiatric/Mental Health PastSince May 20, 2025 Accepting new patients
Los Gatos Therapy Center PastSince Apr 17, 2022 Accepting new patients
WK Medical Group Psychiatric/Mental Health PastSince Aug 7, 2021 Accepting new patients

Locations

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

3260 Kerner Blvd
San Rafael, CA 94901
Phone (415) 507-4030

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1770695967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-484-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-444-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZ",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "credential": "NP RN CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "622677",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "15767",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1693",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "15767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.