Kathleen Renteria, SUDRC-19523

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

SUDRC-19523 Issued in CA

Practice address

17822 Beach Blvd Ste 278
Huntington Beach, CA 92647-7180

Phone

(714) 375-3795

Fax

(714) 375-3795

NPI assigned

Oct 24, 2023

Last updated

Oct 9, 2024By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1891567749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 278",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477180",
            "telephone_number": "714-375-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 278",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477180",
            "telephone_number": "714-375-3795",
            "fax_number": "714-375-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTERIA",
        "first_name": "KATHLEEN",
        "credential": "SUDRC-19523",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "SUDRC-19523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lota N Relato
• Roberto Rende, M.D.
• Jessica Rendin, MD
• Noemi Rendon
• Bianca Renteria Balmaceda
• Tyler Renteria
• Repair Physical Therapy Inc.
• Elsie Resendiz
• Retina Institute of California Medical Group, a California Medical Par (Acuity Eye Group)
• Paulina Reveles, PA-C

• Addiction (Substance Use Disorder) Counselor in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.