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General NPI Number Information
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NPI Number | 1730268145
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Entity Type | Individual
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Provider Name | GINA ELIZABETH TARANGO MASTERS DEGREE
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Gender | Female
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Dates
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Enumeration Date | 11/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 250 W 1ST ST SUITE 214
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City | CLAREMONT
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State | CA
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Zip | 91711-4736
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Country | US
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Telephone | 909-447-6497
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Fax |
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Provider Business Mailing Address
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Address Line | 5051 SUMMERHILL RD
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91737-1689
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Country | US
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Telephone | 909-447-6497
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFC36021
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License Number State | CA
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