Individual
TIFFANI REGACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5200 N LAKE RD APT 5, MERCED, CA 95343-5001
(925) 864-6608
Mailing address
3744 R ST APT 5, MERCED, CA 95348-2286
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000022305
CA
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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