Provider Demographics
NPI:1578819132
Name:LING, TINA TSUN-EN LIU (C GC)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:TSUN-EN LIU
Last Name:LING
Suffix:
Gender:F
Credentials:C GC
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:TSUN-EN
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CGC
Mailing Address - Street 1:5601 DE SOTO AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13640 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-3904
Practice Address - Country:US
Practice Address - Phone:818-375-2073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000327170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS