Provider Demographics
NPI:1053746966
Name:TINOCO, SUSANA FRANCO
Entity type:Individual
Prefix:MS
First Name:SUSANA
Middle Name:FRANCO
Last Name:TINOCO
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 1:103 BARBARA ST
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-1651
Mailing Address - Country:US
Mailing Address - Phone:951-581-2146
Mailing Address - Fax:
Practice Address - Street 1:103 BARBARA ST
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-1651
Practice Address - Country:US
Practice Address - Phone:951-581-2146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor