MR. JUSTICE RENAISSANCE MHRS NPI 1992878326

NPI Information

NPI: 1992878326
Provider Name: MR. JUSTICE RENAISSANCE, MHRS
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
232 E GISH RD
SAN JOSE, CA
ZIP 95112
Phone: (408) 379-3790
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MR. Justice Renaissance, MHRS is a peer specialist in San Jose, CA. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. MR. Justice Renaissance, MHRS NPI is 1992878326. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

232 E GISH RD
SAN JOSE, CA
ZIP 95112-706
Phone: (408) 379-3790

The enumeration date for this NPI number is 11/15/2006 and was last updated on 4/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	COUNTY ID	OTHER	CALIFORNIA	3497

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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