Provider Demographics
NPI:1619966389
Name:DAVIS, REGINA MARIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:MARIE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:533 PARNASSUS AVE
Mailing Address - Street 2:BOX 0720
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2208
Mailing Address - Country:US
Mailing Address - Phone:415-476-0742
Mailing Address - Fax:415-476-6145
Practice Address - Street 1:9756 MIKETO WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-6247
Practice Address - Country:US
Practice Address - Phone:415-967-3375
Practice Address - Fax:415-970-5021
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS