Provider Demographics
NPI:1124794102
Name:DELGADO, CINDY GABRIELA
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:GABRIELA
Last Name:DELGADO
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 1:415 S PROSPECT AVE APT 220
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3946
Mailing Address - Country:US
Mailing Address - Phone:424-400-1441
Mailing Address - Fax:
Practice Address - Street 1:415 S PROSPECT AVE APT 220
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3946
Practice Address - Country:US
Practice Address - Phone:424-400-1441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT148638106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist