Provider Demographics
NPI:1679860035
Name:REMOLACIO, REGINA (FNP)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:REMOLACIO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8325 BRIMHALL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2245
Mailing Address - Country:US
Mailing Address - Phone:661-587-2468
Mailing Address - Fax:661-587-6401
Practice Address - Street 1:8325 BRIMHALL RD STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2245
Practice Address - Country:US
Practice Address - Phone:661-587-2468
Practice Address - Fax:661-587-6401
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19928363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19928OtherFNP