Provider Demographics
NPI:1770465569
Name:TAGAMOLILA, TRINA FAITH QUIA-ONG
Entity type:Individual
Prefix:
First Name:TRINA FAITH
Middle Name:QUIA-ONG
Last Name:TAGAMOLILA
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 1:4000 BRAEMORE AVE APT 1106
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-5730
Mailing Address - Country:US
Mailing Address - Phone:219-315-4161
Mailing Address - Fax:
Practice Address - Street 1:4000 BRAEMORE AVE APT 1106
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46637-5730
Practice Address - Country:US
Practice Address - Phone:219-315-4161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program