Provider Demographics
NPI:1396244992
Name:TESSINA, TINA BELLOCCHIO (MFT 13629)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:BELLOCCHIO
Last Name:TESSINA
Suffix:
Gender:F
Credentials:MFT 13629
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 JUNIPERO AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3507
Mailing Address - Country:US
Mailing Address - Phone:562-438-8077
Mailing Address - Fax:562-684-4302
Practice Address - Street 1:1055 JUNIPERO AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3507
Practice Address - Country:US
Practice Address - Phone:562-438-8077
Practice Address - Fax:562-438-8077
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13629106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist