Provider Demographics
NPI:1831288315
Name:FINO, DOREEN APRIL (MA)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:APRIL
Last Name:FINO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:DOREEN
Other - Middle Name:APRIL
Other - Last Name:MERCADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2601 E 19TH ST
Mailing Address - Street 2:UNIT 20
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-1156
Mailing Address - Country:US
Mailing Address - Phone:562-760-7772
Mailing Address - Fax:
Practice Address - Street 1:110 W OCEAN BLVD STE 18
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4625
Practice Address - Country:US
Practice Address - Phone:714-935-6056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 42034106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist