Provider Demographics
NPI:1710032768
Name:PANGELINA, TRINA ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TRINA
Middle Name:ANN
Last Name:PANGELINA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25500 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 1240
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6829
Mailing Address - Country:US
Mailing Address - Phone:310-373-5711
Mailing Address - Fax:310-373-0571
Practice Address - Street 1:25500 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 1240
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6829
Practice Address - Country:US
Practice Address - Phone:310-373-5711
Practice Address - Fax:310-373-0571
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19161103T00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent