Basic Information
| Provider Information | |||||||||
| NPI: | 1770770778 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIPERSBURG | ||||||||
| FirstName: | REGINA | ||||||||
| MiddleName: | VERNICE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2619 LONG TER | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934557439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057398500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 429 N SAN ANTONIO RD | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931101399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8058841629 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2007 | ||||||||
| LastUpdateDate: | 10/03/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | A6536119 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.