Healthcare Provider Details

I. General information

NPI: 1427370006
Provider Name (Legal Business Name): REGINA AW DARLING MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REGINA ANTANETTE WILLIAMS MS CCC-SLP

II. Dates (important events)

Enumeration Date: 02/23/2010
Last Update Date: 02/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

785 GRAND AVE SUITE 208
CARLSBAD CA
92008-2370
US

IV. Provider business mailing address

785 GRAND AVE SUITE 208
CARLSBAD CA
92008-2370
US

V. Phone/Fax

Practice location:
  • Phone: 760-730-9675
  • Fax: 760-730-9669
Mailing address:
  • Phone: 760-730-9675
  • Fax: 760-730-9669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP 12774
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: