Provider Demographics
NPI:1871933416
Name:REGINELLI, MERRILY NICOLE (CD, CPD, LCCE)
Entity type:Individual
Prefix:MRS
First Name:MERRILY
Middle Name:NICOLE
Last Name:REGINELLI
Suffix:
Gender:F
Credentials:CD, CPD, LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 PARK WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-2646
Mailing Address - Country:US
Mailing Address - Phone:650-388-0102
Mailing Address - Fax:
Practice Address - Street 1:624 PARK WAY
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-2646
Practice Address - Country:US
Practice Address - Phone:650-388-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN