Provider Demographics
NPI:1104407741
Name:REGIER, RYAN THOMAS
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:THOMAS
Last Name:REGIER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 N CLARK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4842
Mailing Address - Country:US
Mailing Address - Phone:559-492-2266
Mailing Address - Fax:
Practice Address - Street 1:3845 N CLARK ST STE 201
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4842
Practice Address - Country:US
Practice Address - Phone:559-512-6459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125559106H00000X
CA146514106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist