Provider Demographics
NPI:1144343583
Name:RENFROE, SHARRON KAY (MFT)
Entity type:Individual
Prefix:MRS
First Name:SHARRON
Middle Name:KAY
Last Name:RENFROE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2615
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92859-0615
Mailing Address - Country:US
Mailing Address - Phone:714-771-2134
Mailing Address - Fax:
Practice Address - Street 1:414 EASTSIDE AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4320
Practice Address - Country:US
Practice Address - Phone:714-771-2134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC27450106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist