Provider Demographics
NPI:1922412907
Name:GLISHICH, TINA (MS)
Entity Type:Individual
Prefix:MS
First Name:TINA
Middle Name:
Last Name:GLISHICH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:SAVKA
Other - Middle Name:
Other - Last Name:LJUBOJE-GLISHICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS MFT
Mailing Address - Street 1:6147 SUTTER AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2738
Mailing Address - Country:US
Mailing Address - Phone:916-971-7640
Mailing Address - Fax:916-971-5711
Practice Address - Street 1:6147 SUTTER AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2738
Practice Address - Country:US
Practice Address - Phone:916-971-7640
Practice Address - Fax:916-971-5711
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist