Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 412 | CA |
NPI | 1154728533 |
---|---|
Provider Name | Renee Lepreau |
First Address | Berkeley, CA 94710-2319 |
Second Address | Berkeley, CA 94710-2319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2014 |
Last Update Date | 01/12/2014 |