Provider Demographics
NPI:1124758172
Name:VALENTINE, CYNTHIA C (LMFT)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:C
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3979 KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2910
Mailing Address - Country:US
Mailing Address - Phone:707-235-6098
Mailing Address - Fax:
Practice Address - Street 1:3979 KANSAS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-2910
Practice Address - Country:US
Practice Address - Phone:707-235-6098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108089106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist