Doctor Name: | MS. REGINA BURGOS |
NPI Number: | 1194136754 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 95000624 |
Business Practice Address: | 500 W Hospital Rd French Camp, CA - 952319693 |
Business Phone Number: | 2094686820 |
Business Fax Number: | |
Mailing Address: | 1414 N California St, STOCKTON |
State: | CA |
Postal Code: | 952021515 |
Phone Number: | 2094689542 |
Fax Number: | 2094689539 |
NPI Enumeration Date: | 05/16/2014 |
NPI Last Update Date: | 03/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 95000624 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |