Provider Demographics
NPI:1538340948
Name:TINTOR, JINA (LCSW)
Entity type:Individual
Prefix:
First Name:JINA
Middle Name:
Last Name:TINTOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JINA
Other - Middle Name:
Other - Last Name:HWANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3741 STOCKER ST STE 201
Mailing Address - Street 2:
Mailing Address - City:VIEW PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90008-5148
Mailing Address - Country:US
Mailing Address - Phone:626-327-3618
Mailing Address - Fax:
Practice Address - Street 1:8730 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-4830
Practice Address - Country:US
Practice Address - Phone:323-751-3026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW65602101YM0800X, 104100000X
CA853181041C0700X
CALCSW853181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker