Provider Demographics
NPI:1730329210
Name:GAMINO, RENA MARIE (MS, PSYD)
Entity type:Individual
Prefix:DR
First Name:RENA
Middle Name:MARIE
Last Name:GAMINO
Suffix:
Gender:F
Credentials:MS, PSYD
Other - Prefix:MISS
Other - First Name:RENA
Other - Middle Name:MARIE
Other - Last Name:VASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2737 W CECIL AVE
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-1821
Mailing Address - Country:US
Mailing Address - Phone:661-721-2345
Mailing Address - Fax:
Practice Address - Street 1:3628 STOCKDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-2153
Practice Address - Country:US
Practice Address - Phone:661-322-1021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF59257106H00000X
CA33184103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist