Provider Demographics
NPI:1033665823
Name:UY, REGINA
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:
Last Name:UY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:REGINA
Other - Middle Name:AGUILO
Other - Last Name:MANAIG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9952 BARCELONA CT
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-3044
Mailing Address - Country:US
Mailing Address - Phone:619-339-1731
Mailing Address - Fax:
Practice Address - Street 1:8509 DALLAS ST
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3120
Practice Address - Country:US
Practice Address - Phone:619-339-1731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility