Provider Demographics
NPI:1780553479
Name:GARNER, REGINA FRANCINE (LMT, AS)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:FRANCINE
Last Name:GARNER
Suffix:
Gender:F
Credentials:LMT, AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 E WILLIAMS ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-5865
Mailing Address - Country:US
Mailing Address - Phone:909-205-2313
Mailing Address - Fax:
Practice Address - Street 1:1424 E WILLIAMS ST APT 1
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-5865
Practice Address - Country:US
Practice Address - Phone:909-205-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-01
Last Update Date:2025-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23087225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist