Provider Demographics
NPI:1548477599
Name:MCCREERY, RENO EDWARD (MHA III PSC)
Entity type:Individual
Prefix:MR
First Name:RENO
Middle Name:EDWARD
Last Name:MCCREERY
Suffix:
Gender:M
Credentials:MHA III PSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3077 FITE CIR STE 6
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1815
Mailing Address - Country:US
Mailing Address - Phone:916-854-1801
Mailing Address - Fax:916-854-1809
Practice Address - Street 1:3077 FITE CIR STE 6
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1815
Practice Address - Country:US
Practice Address - Phone:916-854-1801
Practice Address - Fax:916-854-1809
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3463OtherCATS