Provider Demographics
NPI:1841055647
Name:AQUINO, MA REGINA AURE (NP)
Entity type:Individual
Prefix:
First Name:MA REGINA
Middle Name:AURE
Last Name:AQUINO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MA REGINA
Other - Middle Name:AQUINO
Other - Last Name:MAGSI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:10948 TYLER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2655 CAMINO DEL RIO N
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1633
Practice Address - Country:US
Practice Address - Phone:800-334-8603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023087363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner