Healthcare Provider Details

I. General information

NPI: 1518278795
Provider Name (Legal Business Name): REGINA BORDIERI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 03/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W MISSION AVE STE 103
ESCONDIDO CA
92025-1721
US

IV. Provider business mailing address

125 W MISSION AVE STE 103
ESCONDIDO CA
92025-1721
US

V. Phone/Fax

Practice location:
  • Phone: 760-747-3424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: