Provider Demographics
NPI:1144804576
Name:PARKER, REGINA FELICIA (CPT1)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:FELICIA
Last Name:PARKER
Suffix:
Gender:F
Credentials:CPT1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10770 JOSHUA ST
Mailing Address - Street 2:
Mailing Address - City:ADELANTO
Mailing Address - State:CA
Mailing Address - Zip Code:92301-4124
Mailing Address - Country:US
Mailing Address - Phone:760-623-5535
Mailing Address - Fax:800-708-1108
Practice Address - Street 1:15000 7TH ST STE 212D
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3852
Practice Address - Country:US
Practice Address - Phone:626-788-1230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT00069348246RP1900X, 246R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246R00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Pathology
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy