Individual
REGINA BACANI DIZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1501 SUPERIOR AVE STE 300, NEWPORT BEACH, CA 92663-3641
(949) 996-5355
(949) 806-6901
Mailing address
1501 SUPERIOR AVE STE 300, NEWPORT BEACH, CA 92663-3641
(949) 996-5355
(949) 806-6901
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95018663
CA
Other
Enumeration date
10/13/2021
Last updated
10/14/2024
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