Larissa Lee Renna, LMT, MMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT-13323 Issued in AZ

Practice address

2025 S Davis Cir
Mesa, AZ 85210-6706

Phone

(602) 577-9984

NPI assigned

Apr 4, 2011

Last updated

Apr 4, 2011By 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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1992094668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 S DAVIS CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106706",
            "telephone_number": "602-577-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 S DAVIS CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106706",
            "telephone_number": "602-577-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNA",
        "first_name": "LARISSA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LMT, MMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-13323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renal Care Group Arizona, LLC (Renal Care Group - Home Dialysis of Mesa)
• Lizbeth A Rencher, PH.D.
• Renewal Healing Chiropractic
• Renewed Spirit Residences LLC
• Tia Renko
• Dustin Andrew Renoth
• Julia Rensch, MS, LAC
• Repower Medical Clinic, LLC
• Rescare Residential Services Arizona, LLC (A Place to Call Home)
• Michelle Resendez, FNP-C

• Massage Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Massage Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.