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General NPI Number Information
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NPI Number | 1548296650
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Entity Type | Individual
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Provider Name | REGINA M PETRIKAS NP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 4305 TORRANCE BLVD STE 106
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City | TORRANCE
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State | CA
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Zip | 90503-4400
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Country | US
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Telephone | 310-542-9758
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Fax |
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Provider Business Mailing Address
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Address Line | 3164 N GREENBRIER RD
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City | LONG BEACH
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State | CA
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Zip | 90808-3436
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Country | US
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Telephone | 562-420-9950
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP9207
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License Number State | CA
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