Provider Demographics
NPI:1154821585
Name:TUVALU, GINA
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:TUVALU
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 1:3430 COGSWELL RD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-2785
Mailing Address - Country:US
Mailing Address - Phone:626-453-3406
Mailing Address - Fax:626-246-3433
Practice Address - Street 1:360 S WESTLAKE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2906
Practice Address - Country:US
Practice Address - Phone:213-483-9201
Practice Address - Fax:213-382-0136
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)