Provider Demographics
NPI:1922562446
Name:HINGA, CHARLES (LMFT 134755)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:HINGA
Suffix:
Gender:M
Credentials:LMFT 134755
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11428 KENYON WAY
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-9234
Mailing Address - Country:US
Mailing Address - Phone:909-948-1065
Mailing Address - Fax:
Practice Address - Street 1:11428 KENYON WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91701-9234
Practice Address - Country:US
Practice Address - Phone:909-948-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
CA115700106H00000X
CA134755106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health