Individual
REGINA ANN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 CLAUS ROAD, MODESTO, CA 95355-9335
(209) 558-4600
Mailing address
1617 ATLANTIC AVE, RIPON, CA 95366-9335
(209) 599-5569
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
621685
CA
Other
Enumeration date
07/31/2007
Last updated
07/31/2007
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