Provider Demographics
NPI:1104103878
Name:PARDO-NIETO, CYNTHIA (RASI)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:PARDO-NIETO
Suffix:
Gender:F
Credentials:RASI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 MIDDLE RINCON RD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95409
Mailing Address - Country:US
Mailing Address - Phone:707-335-0702
Mailing Address - Fax:707-571-5531
Practice Address - Street 1:540 MIDDLE RINCON RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95409
Practice Address - Country:US
Practice Address - Phone:707-335-0702
Practice Address - Fax:707-571-5531
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)