Healthcare Provider Details

I. General information

NPI: 1710840392
Provider Name (Legal Business Name): MARIA HINTOG APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA PATRICIA HINTOG APCC

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 E COLORADO BLVD STE 501
PASADENA CA
91101-2017
US

IV. Provider business mailing address

1361 N GARFIELD AVE
PASADENA CA
91104-2104
US

V. Phone/Fax

Practice location:
  • Phone: 323-208-9890
  • Fax:
Mailing address:
  • Phone: 818-923-8735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number18954
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: