MEDICARE: REGAL REJUVENATION NURSING, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse

General Provider Information

NPI Number	:	1770436834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGAL REJUVENATION NURSING, PC

Provider Business Mailing Address
First Line	:	9701 WILSHIRE BLVD STE 1046
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-2020
Country	:	US
Telephone Number	:	310-220-0489
Fax Number	:

Provider Business Practice Location Address
First Line	:	9701 WILSHIRE BLVD STE 1046
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-2020
Country	:	US
Telephone Number	:	310-220-0489
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CARLISHA FLETCHER
Credential	:	RN
Telephone Number	:	936-346-8065

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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