Provider Demographics
NPI:1962912600
Name:FINNIKIN, TISHANI
Entity type:Individual
Prefix:
First Name:TISHANI
Middle Name:
Last Name:FINNIKIN
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 1:28108 BELFRY CIR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-5414
Mailing Address - Country:US
Mailing Address - Phone:951-488-0611
Mailing Address - Fax:
Practice Address - Street 1:28108 BELFRY CIR
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-5414
Practice Address - Country:US
Practice Address - Phone:951-488-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health