Provider Demographics
NPI:1730070798
Name:REGALADO, MARIELENA
Entity type:Individual
Prefix:
First Name:MARIELENA
Middle Name:
Last Name:REGALADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10089 FOLSOM BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-1935
Mailing Address - Country:US
Mailing Address - Phone:916-366-6531
Mailing Address - Fax:
Practice Address - Street 1:10089 FOLSOM BLVD STE A
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-1935
Practice Address - Country:US
Practice Address - Phone:916-366-6531
Practice Address - Fax:916-366-6532
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker