Provider Demographics
NPI:1952011272
Name:REGIO, MARIE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:REGIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 CALIFORNIA AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1664
Mailing Address - Country:US
Mailing Address - Phone:661-282-9027
Mailing Address - Fax:661-283-0128
Practice Address - Street 1:5300 CALIFORNIA AVE STE 400
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1664
Practice Address - Country:US
Practice Address - Phone:661-282-9027
Practice Address - Fax:661-283-0128
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174467343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA920894146Medicaid