RENEW LIFE CENTER (NPI# 1609004084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609004084 |
| Entity Type | Organization |
| Organization Name | RENEW LIFE CENTER |
| Practice Address |
211 De Anza Blvd San Mateo CA 94402-3989 |
| Practice Telephone | 6503501700 |
| Practice Fax Number | 6503413604 |
| Mailing Telephone | 6503501700 |
| Mailing Fax Number | 6503413604 |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-06-24 |
| Authorized Official Name | DR. JULIETA MARIMLA GABIOLA (PRESIDENT) |
| Authorized Official Telephone | 6503501700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | AG51233 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | AG2356548 | 01 | |
| CA | MEDICAL LICENCE | G51233 | 01 |
| Street Address |
211 DE ANZA BLVD |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94402-3989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154227 | Mark Cameron Head | Non-emergency Medical Transport (VAN) | 331 Sonora Drive, San Mateo, CA 94402 | 2020-11-06 |
| 1669032868 | County of San Mateo | Clinic/Center | 222 Paul Scannell Dr., San Mateo, CA 94402 | 2019-06-19 |
| 1417443755 | Suen Leung | Counselor | 800 Edinburgh St, San Mateo, CA 94402 | 2018-07-10 |
| 1760997902 | Blue Lotus Connection | Point of Service | 1700 S Amphlett Blvd, Ste 250b, San Mateo, CA 94402 | 2017-12-11 |
| 1982122503 | Madeline Pielert | Social Worker | 1670 S. Amphlett Blvd. 115, San Mateo, CA 94402 | 2017-09-04 |
| 1629512348 | Travis Woodmansee | Marriage & Family Therapist | 419 S El Dorado St, San Mateo, CA 94402 | 2016-12-14 |
| 1669820858 | Mohan Sundareson | Pediatrics | 1638 South Grant St, San Mateo, CA 94402 | 2016-05-27 |
| 1457712572 | New Life Acupuncture Clinic | Acupuncturist | 1720 South Amphlett Blvd # 168, San Mateo, CA 94402 | 2016-03-17 |
| 1871951434 | Nanami Oba | Physical Therapy Assistant | 20 Bennigton Dr., San Mateo, CA 94402 | 2016-02-10 |
| 1780059733 | Adrianna Cimera | Behavioral Analyst | 1710 South Amphlett Blvd, Suite 314, San Mateo, CA 94402 | 2015-12-02 |
| Find all providers in zip 94402 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528520061 | Zen Lounge Acupuncture Inc | Clinic/Center | 2996 S Norfolk St Ste F, San Mateo, CA 94403-2076 | 2019-04-03 |
| 1497186886 | Caminar | Clinic/Center | 416 2nd Ave, San Mateo, CA 94401 | 2013-12-10 |
| 1316235864 | Jnz Medical Group, LLC | Clinic/Center | 709a Woodside Way, San Mateo, CA 94401-1686 | 2011-07-19 |
| 1871701581 | Planned Parenthood Golden Gate | Clinic/Center | 2205 Palm Ave, San Mateo, CA 94403-1814 | 2007-05-18 |
| 1922019397 | Planned Parenthood Golden Gate | Clinic/Center | 2211 Palm Ave, San Mateo, CA 94403-1814 | 2006-08-11 |
| 1528685500 | Wholesome Medical Center | Clinic/Center | 100a S El Camino Real, San Mateo, CA 94401-3810 | 2020-06-25 |
| 1356843171 | Healthright 360 | Clinic/Center | 3701 Hacienda St, San Mateo, CA 94403-4366 | 2018-03-07 |
| 1144767021 | Shu Chiropractic and Associates Corporation | Clinic/Center | 407 N San Mateo Dr, Suite 5, San Mateo, CA 94401-2417 | 2017-01-30 |
| 1801141874 | Yuan Yi Acupuncture Clinic | Clinic/Center | 101 N El Camino Real, Suite 4, San Mateo, CA 94401-2700 | 2012-07-16 |
| 1184789083 | San Mateo Medical Centerr | Clinic/Center | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2006-12-22 |
| Find all providers in SAN MATEO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.