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General NPI Number Information
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NPI Number | 1851841068
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Entity Type | Individual
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Provider Name | HEA JIN KO MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 10775 PIONEER TRL STE 215
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City | TRUCKEE
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State | CA
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Zip | 96161-0234
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Country | US
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Telephone | 415-424-4266
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Fax | 415-520-6633
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Provider Business Mailing Address
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Address Line | 8300 ESTERS BLVD STE 900
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City | IRVING
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State | TX
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Zip | 75063-2233
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Country | US
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Telephone | 415-424-4266
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Fax | 415-520-6633
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 132261
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License Number State | CA
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