Basic Information
| Provider Information | |||||||||
| NPI: | 1174605778 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELEW | ||||||||
| FirstName: | RENEE | ||||||||
| MiddleName: | VESTA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5336 1/2 HERMITAGE AVE | ||||||||
| Address2: | |||||||||
| City: | VALLEY VILLAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 916074211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188322410 | ||||||||
| FaxNumber: | 8188322409 | ||||||||
| Practice Location | |||||||||
| Address1: | 10605 BALBOA BLVD | ||||||||
| Address2: | #100 | ||||||||
| City: | GRANADA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913446342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188322410 | ||||||||
| FaxNumber: | 8188322409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 23558 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.