Provider Demographics
NPI:1801909601
Name:CHO, TINA (LMFT)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-3247
Mailing Address - Country:US
Mailing Address - Phone:951-955-7107
Mailing Address - Fax:951-955-7207
Practice Address - Street 1:3801 UNIVERSITY AVE
Practice Address - Street 2:400
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3247
Practice Address - Country:US
Practice Address - Phone:951-955-7107
Practice Address - Fax:951-955-7207
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33573106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist