Active NPI
Julie Rose Regan, M.S.
- Mental Health Counselor
- San Diego, CA
National Provider Identifier
1801097605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMF55989
- Practice address
- 3255 Wing St
Ste. 500
San Diego, CA 92110-4638 - Phone
- (619) 221-8600
- NPI assigned
- May 30, 2007
- Last updated
- Jan 5, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | RC00053396 | WA | |
| Mental Health Counselor | 101YM0800X | IMF55989 | CA | Primary |
Addresses
Primary practice location
3255 Wing St
Ste. 500
San Diego, CA 92110-4638
Mailing address
12006 Clover Ave
Los Angeles, CA 90066-1004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC00053396 | WA | MD | Counselor |
| IMF55989 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231113600000",
"number": "1801097605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12006 CLOVER AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900661004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3255 WING ST",
"address_2": "STE. 500",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921104638",
"telephone_number": "619-221-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGAN",
"first_name": "JULIE",
"middle_name": "ROSE",
"name_prefix": "Miss",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-30",
"last_updated": "2009-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "RC00053396",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "IMF55989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.