Eliza Renwick, 394589

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

394589 Issued in CA

Practice address

180 Sierra College Dr
Grass Valley, CA 95945-5768

Phone

(530) 271-1140

Fax

(530) 271-7036

NPI assigned

Dec 11, 2015

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Granite Wellness Centers

  • Community/Behavioral Health Agency
  • Grass Valley, CA
  • NPI 1750500237
  NPD (past)

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1871968180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 SIERRA COLLEGE DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455768",
            "telephone_number": "530-271-1140",
            "fax_number": "530-271-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 SIERRA COLLEGE DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455768",
            "telephone_number": "530-271-1140",
            "fax_number": "530-271-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENWICK",
        "first_name": "ELIZA",
        "credential": "394589",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "394589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony L Reichmuth
• June Ellen Reiersen, RADT
• Katie Reinhardt Ianni
• Rene' C. Kronland MD, Inc
• Kristina Renn, PPSC
• Alfred Ressel, RPH
• Matthew B Reveis
• Heidi Rex
• Itzel Reyna
• Gregory Arno Reynolds, MD

• All providers in Grass Valley, CA
• Addiction (Substance Use Disorder) Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.