Willard John Renzema, MS MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 42410 Issued in CA

Practice address

32810 Secretariat CT
Menifee, CA 92584-7843

Phone

(951) 679-1747

Fax

(951) 672-9792

NPI assigned

Nov 24, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Marriage & Family Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1801293576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32810 SECRETARIAT CT",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925847843",
            "telephone_number": "951-679-1747",
            "fax_number": "951-672-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32810 SECRETARIAT CT",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925847843",
            "telephone_number": "951-679-1747",
            "fax_number": "951-672-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZEMA",
        "first_name": "WILLARD",
        "middle_name": "JOHN",
        "credential": "MS MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-24",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 42410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Reiter
• Amber Remaly
• Lauren Michelle Reminger, LMFT
• Renew Path Recovery LLC.
• Alicia Renteria
• Retina Institute of California Medical Group
• Reveal It Aesthetics and Wellness, LLC
• Reviving You Recovery House LLC
• Reviving You Recovery House LLC
• Victoria Rew

• Marriage & Family Therapist in Menifee, CA
• Providers in Menifee, 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 Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.