Provider Demographics
NPI:1972379212
Name:BENSON, REGINA (CVD(TVL))
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:CVD(TVL)
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2113 SYMPHONY AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-8627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2113 SYMPHONY AVE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-8627
Practice Address - Country:US
Practice Address - Phone:916-469-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula