Provider Demographics
NPI:1063192797
Name:SYDNOR, CIN
Entity type:Individual
Prefix:
First Name:CIN
Middle Name:
Last Name:SYDNOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25052 WALNUT ST APT 210
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-1051
Mailing Address - Country:US
Mailing Address - Phone:818-967-9867
Mailing Address - Fax:
Practice Address - Street 1:27200 TOURNEY RD STE 255
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4983
Practice Address - Country:US
Practice Address - Phone:661-222-8901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician