Provider Demographics
NPI:1578333498
Name:STRATTON, REGINA MARIE (CNM)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:MARIE
Last Name:STRATTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24843 APPLE ST UNIT E
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2645
Mailing Address - Country:US
Mailing Address - Phone:818-744-2648
Mailing Address - Fax:
Practice Address - Street 1:24843 APPLE ST UNIT E
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2645
Practice Address - Country:US
Practice Address - Phone:818-744-2648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236431367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty