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Individual

JAMES ARISS REGGIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N. P.

Contact information

Practice address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4170
Mailing address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4971

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
15581
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FHC 70042F
MEDI-CAL PROVIDER# IN SANTA CRUZ COUNTY
CA
01
FHC 70044F
MEDI-CAL PROVIDER# IN SANTA CRUZ COUNTY
CA
01
ZZZ91891Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
01
ZZZ91892Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN
CA
01
ZZZ92069Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN
CA
Enumeration date
07/21/2006
Last updated
07/27/2016
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