Regina Lynn Koller, LPCC, CADC-II

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2471 Issued in CA

Practice address

11440 W Bernardo CT Ste 300
San Diego, CA 92127-1644

Phone

(858) 295-0594

NPI assigned

Nov 6, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Professional

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657411200000",
    "number": "1538446455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11440 W BERNARDO CT STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11440 W BERNARDO CT STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271644",
            "telephone_number": "858-295-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "REGINA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPCC, CADC-II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-06",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RA862911",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "2471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lara Joan Koljonen, L.AC.
• Stephen Kolkow, M.D.
• Elise Kollar
• Tarina Frances Ann Kollars, LMFT
• Vijay S. Kollengode, M.D.
• Aditya Kollipara
• Nancy Ruth Kollisch, M.D.
• Gavin Kolodge
• Alice Kolodji, NP
• David J Kolodji, CRNA

• Professional Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.