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NPI Code Detail

MEDICARE: MS. REGINA PHELPS R.H.S.

MEDICARE: MS. REGINA PHELPS R.H.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1285711564
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. REGINA PHELPS R.H.S.
Provider Business Mailing Address
First Line : 1300 N L ST APT 278
Second Line :
City : LOMPOC
State : CA
Zip : 93436-3364
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 W FOSTER RD
Second Line :
City : SANTA MARIA
State : CA
Zip : 93455-3620
Country : US
Telephone Number : 805-934-6590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 05/16/2011

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