Provider Demographics
NPI:1548467145
Name:BISHOP, RENEE (CNM)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:GIARDINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:5410 LA JOLLA BLVD
Mailing Address - Street 2:A306
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:404-849-7953
Mailing Address - Fax:858-882-8383
Practice Address - Street 1:9333 GENESEE AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-882-8350
Practice Address - Fax:858-882-8383
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN148099367A00000X
CA1896367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife