RENEE ANN FAGEN (NPI# 1619456910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619456910 |
| Entity Type | Individual |
| Full Name | RENEE ANN FAGEN |
| Credential | PSY.D. |
| Practice Address |
1551 Indian Hills Dr Sioux City IA 51104-1859 |
| Mailing Address |
200 E Ash St Cleghorn IA 51014-7724 |
| Practice Telephone | 7122584700 |
| Practice Fax Number | 7122584777 |
| Mailing Telephone | 5154187717 |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-08-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
088631 | IA | Behavioral Health & Social Service Providers |
| Street Address |
1551 INDIAN HILLS DR |
| City | SIOUX CITY |
| State | IA |
| Zip Code | 51104-1859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063458636 | Carl Edwin Peters | Physician Assistant | 1551 Indian Hills Dr, Sioux City, IA 51104-1859 | 2006-06-21 |
| 1922491638 | Simple Life, Inc. | Community/Behavioral Health | 1551 Indian Hills Dr, Suite 4, Sioux City, IA 51104-1859 | 2015-03-05 |
| 1144552068 | Northside Chiropractic Wellness Center Plc | Chiropractor | 1551 Indian Hills Dr, Suite 8, Sioux City, IA 51104-1859 | 2010-02-03 |
| 1689813255 | Professional Portable Radiologic Services, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1551 Indian Hills Dr, #104, Sioux City, IA 51104-1859 | 2009-02-05 |
| 1174799225 | Michael P Baker Dba Associates for Psycholoigcal & Therapy Services | Counselor | 1551 Indian Hills Dr, Suite 221, Sioux City, IA 51104-1859 | 2008-05-07 |
| 1588705339 | Karen L Wall | Counselor | 1551 Indian Hills Dr, Suite 221, Sioux City, IA 51104-1859 | 2007-02-12 |
| 1114095403 | Indian Hills Pharmacy | Pharmacist | 1551 Indian Hills Dr, Ste 101, Sioux City, IA 51104-1859 | 2006-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578944435 | Family First Dental Associates of Iowa, P.C. | Dentist | 2100 Indian Hills Drive, Sioux City, IA 51104 | 2015-06-16 |
| 1740590785 | Khatu Vivienne Erlbacher | Pharmacist | 515 North Briar Path, Sioux City, IA 51104 | 2010-10-08 |
| 1730407545 | Randall Glen Wood | Emergency Medicine | 2720 Stone Park Blvd., Sioux City, IA 51104 | 2010-05-04 |
| 1790811024 | Fred R Rizk | Dentist | 1923 Nebraska Street, Siuox City, IA 51104 | 2007-02-23 |
| 1255474029 | Edilia Maria Marshall | Dentist | Summit Dental, 2114 Pierce St, Sioux City, IA 51104 | 2007-02-14 |
| 1063553410 | Thomas Leonard Tiedeman | Dentist | 2918 Hamilton Blvd, Upper D Suite 1, Sioux City, IA 51104 | 2007-02-09 |
| 1336209188 | Shawn Robert Walton | Dentist | 2410 Pierce Street, Sioux City, IA 51104 | 2006-12-11 |
| 1477649556 | Timothy R Kuntz | Dentist | 3012 Hamilton Blvd, Sioux City, IA 51104 | 2006-10-05 |
| 1528162732 | Duane Kent Nelson | Orthopaedic Surgery | 2800 Peirce St, Suite 101, Sioux City, IA 51104 | 2006-09-08 |
| 1659482206 | Shawn R Walton | Dentist | 2928 Hamilton Blvd, Suite 102, Sioux City, IA 51104 | 2006-08-31 |
| Find all providers in zip 51104 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487938643 | Open Arms Psychological Services, LLC | Psychologist | 4242 Gordon Dr, Suite 101, Sioux City, IA 51106-1376 | 2011-10-06 |
| 1801400155 | Bethink, Pllc | Psychologist | 1214 Pierce St, Sioux City, IA 51105-1417 | 2020-09-03 |
| 1831516699 | Clifford Millard | Psychologist | 800 5th St, Sioux City, IA 51101-1317 | 2014-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245889104 | Psychology Iowa Pllc | Psychologist | 3703 Douglas Ave, Des Moines, IA 50310-5347 | 2019-09-04 |
| 1760044929 | Holistic Resources LLC | Psychologist | 6 Hawkeye Dr Ste 101, North Liberty, IA 52317-8904 | 2019-07-08 |
| 1669934121 | Nelson-johnson Inc | Psychologist | 4923 Lincoln Way Ste 102, Ames, IA 50014-3616 | 2019-04-03 |
| 1538672928 | Julia Van Liew | Psychologist | 3600 30th St Ste -117, Des Moines, IA 50310-5753 | 2017-11-08 |
| 1841718954 | Ashley Kathleen Norwood-strickland | Psychologist | 148 Penfro Dr, Iowa City, IA 52246 | 2017-09-08 |
| 1124554555 | Terry Wayne Mason | Psychologist | 3705 Fletcher Blvd, Ames, IA 50010-4167 | 2017-05-04 |
| 1831547439 | Jessica Brooke Virzi | Psychologist | 3401 Cullen Dr, Ames, IA 50010-1164 | 2016-05-25 |
| 1710383757 | Kevin Kilcawley | Psychologist | 2024 Nw 92nd Ct Ste 12, Clive, IA 50325-5462 | 2014-11-18 |
| 1699189100 | Tracy Ann Thomas | Psychologist | 712 Emerald Dr, Storm Lake, IA 50588-2719 | 2014-06-12 |
| 1407289580 | Sunde Michele Nesbit | Psychologist | 3823 Berkshire Ave, Ames, IA 50010-3943 | 2013-08-13 |
| Find all providers with the same taxonomy | ||||
| City | SIOUX CITY |
| Zip Code | 51104 |
Please comment or provide details below to improve the information on RENEE ANN FAGEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.