Provider Demographics
NPI:1013684976
Name:HAUGABOOK, REGINA (LCSW)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:HAUGABOOK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 MARINA BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:BRISBANE
Mailing Address - State:CA
Mailing Address - Zip Code:94005-1887
Mailing Address - Country:US
Mailing Address - Phone:415-502-2581
Mailing Address - Fax:415-514-8288
Practice Address - Street 1:8000 MARINA BLVD STE 600
Practice Address - Street 2:
Practice Address - City:BRISBANE
Practice Address - State:CA
Practice Address - Zip Code:94005-1887
Practice Address - Country:US
Practice Address - Phone:415-502-2581
Practice Address - Fax:415-514-8288
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
CALCSW1019171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251S00000XAgenciesCommunity/Behavioral Health