Healthcare Provider Details

I. General information

NPI: 1568366128
Provider Name (Legal Business Name): CRISTINE ELIZABETH REGALA JAVIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 SECRET RAVINE PKWY STE 120
ROSEVILLE CA
95661-6042
US

IV. Provider business mailing address

1411 SECRET RAVINE PKWY STE 120
ROSEVILLE CA
95661-6042
US

V. Phone/Fax

Practice location:
  • Phone: 916-780-4200
  • Fax: 916-780-4201
Mailing address:
  • Phone: 916-780-4200
  • Fax: 916-780-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU4240
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: