Healthcare Provider Details

I. General information

NPI: 1225331432
Provider Name (Legal Business Name): REGINA DAMPIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 WALL ST STE 300
SAINT CHARLES MO
63303-3541
US

IV. Provider business mailing address

135 S STATE COLLEGE BLVD STE 350
BREA CA
92821-5814
US

V. Phone/Fax

Practice location:
  • Phone: 888-777-1945
  • Fax:
Mailing address:
  • Phone: 805-505-7757
  • Fax: 805-413-9099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2010040042
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: