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NPI 1811012404

NPI 1811012404 : REGINA KENTNER CHILDRESS PSYD : SACRAMENTO, CA

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General NPI Number Information
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    NPI Number           |    1811012404
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    Entity Type          |    Individual 
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    Provider Name        |    REGINA KENTNER CHILDRESS PSYD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/20/2007
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    Last Update Date     |    10/21/2025
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Provider Practice Location Address
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    Address Line         |    651 I ST 
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    City                 |    SACRAMENTO
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    State                |    CA
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    Zip                  |    95814-2400
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    Country              |    US
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    Telephone            |    916-805-3852
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 279432 
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    City                 |    SACRAMENTO
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    State                |    CA
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    Zip                  |    95827-9432
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    Country              |    US
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    Telephone            |    
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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        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    PSY23311
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    License Number State |    CA
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