Provider Demographics
NPI:1962085597
Name:JENKINS, MARIA-CARINA REGALA (LCSW)
Entity type:Individual
Prefix:
First Name:MARIA-CARINA
Middle Name:REGALA
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MARI
Other - Middle Name:REGALA
Other - Last Name:KLINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:7065 MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-1840
Mailing Address - Country:US
Mailing Address - Phone:619-358-3066
Mailing Address - Fax:
Practice Address - Street 1:7850 VISTA HILL AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2717
Practice Address - Country:US
Practice Address - Phone:619-358-3066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA886201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical