Provider Demographics
NPI:1952577181
Name:SNOOK, TINA N (LPCC)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:N
Last Name:SNOOK
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:N
Other - Last Name:KLOTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 W VISTA WAY STE 202
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-5736
Mailing Address - Country:US
Mailing Address - Phone:760-305-4777
Mailing Address - Fax:
Practice Address - Street 1:550 W VISTA WAY STE 202
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-5736
Practice Address - Country:US
Practice Address - Phone:760-305-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA348101YM0800X, 101YP2500X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner