Basic Information
| Provider Information | |||||||||
| NPI: | 1801909601 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHO | ||||||||
| FirstName: | TINA | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3801 UNIVERSITY AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925013247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519557107 | ||||||||
| FaxNumber: | 9519557207 | ||||||||
| Practice Location | |||||||||
| Address1: | 3801 UNIVERSITY AVE | ||||||||
| Address2: | 400 | ||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925013247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519557107 | ||||||||
| FaxNumber: | 9519557207 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 04/19/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC33573 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.