Provider Demographics
NPI:1760884209
Name:EVANS RENO, TINELLE RENEE (LPCC)
Entity type:Individual
Prefix:
First Name:TINELLE
Middle Name:RENEE
Last Name:EVANS RENO
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4012 GALBRATH DR
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-3417
Mailing Address - Country:US
Mailing Address - Phone:916-514-2818
Mailing Address - Fax:
Practice Address - Street 1:4012 GALBRATH DR
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-3417
Practice Address - Country:US
Practice Address - Phone:916-514-2818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4542101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health