Provider Demographics
NPI:1982055430
Name:SPEIGHTS, REGINA WIGGINS (DNP, FNP-C, PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:WIGGINS
Last Name:SPEIGHTS
Suffix:
Gender:F
Credentials:DNP, FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11321 IOWA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4260
Mailing Address - Country:US
Mailing Address - Phone:310-844-3440
Mailing Address - Fax:725-209-1284
Practice Address - Street 1:11321 IOWA AVE STE 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4260
Practice Address - Country:US
Practice Address - Phone:310-844-3440
Practice Address - Fax:725-209-1284
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2023-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1076145363LF0000X, 363LP0808X
FL9380575363LF0000X, 363LP0808X
WAAP60667620363LF0000X
NVAPRN002260363LF0000X, 363LP0808X
CA95008271363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1982055430Medicaid
NVPENDINGMedicare PIN