Provider Demographics
NPI:1255137956
Name:GARDEA, REGINA LORIENE (LMFT, LPCC)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:LORIENE
Last Name:GARDEA
Suffix:
Gender:
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 BROOKHOLLOW DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5401
Mailing Address - Country:US
Mailing Address - Phone:949-393-3344
Mailing Address - Fax:
Practice Address - Street 1:1516 BROOKHOLLOW DR UNIT A
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5401
Practice Address - Country:US
Practice Address - Phone:949-393-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18267101YP2500X
CA147101106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty