Provider Demographics
NPI:1962197681
Name:REINA, REGINA (MS)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:REINA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95605-2563
Mailing Address - Country:US
Mailing Address - Phone:916-524-7874
Mailing Address - Fax:
Practice Address - Street 1:1022 WATERFORD DR
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95605-2563
Practice Address - Country:US
Practice Address - Phone:916-524-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program