Provider Demographics
NPI:1871627273
Name:HELMER, REGINA ELAINE
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:ELAINE
Last Name:HELMER
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 1:6037 MCNEELY WAY
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-1302
Mailing Address - Country:US
Mailing Address - Phone:916-202-1786
Mailing Address - Fax:
Practice Address - Street 1:7408 AUTUMN AVE
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-1302
Practice Address - Country:US
Practice Address - Phone:916-202-1786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X101YM0800X
CA63115106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health