Provider Demographics
NPI:1699826065
Name:XIA, REGINA R (ACUPUNCTURIST)
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:R
Last Name:XIA
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 E ARQUES AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-5422
Mailing Address - Country:US
Mailing Address - Phone:408-524-0676
Mailing Address - Fax:
Practice Address - Street 1:1210 E ARQUES AVE STE 202
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-5422
Practice Address - Country:US
Practice Address - Phone:408-524-0676
Practice Address - Fax:408-524-0663
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4851171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist