Provider Demographics
NPI:1538487137
Name:BANGA, TINA NIHAL KAUR
Entity type:Individual
Prefix:
First Name:TINA NIHAL
Middle Name:KAUR
Last Name:BANGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1889 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-2162
Mailing Address - Country:US
Mailing Address - Phone:408-878-4366
Mailing Address - Fax:
Practice Address - Street 1:1889 LAWRENCE RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-2162
Practice Address - Country:US
Practice Address - Phone:408-878-4366
Practice Address - Fax:408-878-4366
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist