Provider Demographics
NPI:1194001834
Name:CISNEROS, CINDY (PHD)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:CISNEROS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9829 BLUE LARKSPUR LN
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-6535
Mailing Address - Country:US
Mailing Address - Phone:831-647-8490
Mailing Address - Fax:
Practice Address - Street 1:9829 BLUE LARKSPUR LN
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-6535
Practice Address - Country:US
Practice Address - Phone:831-647-8490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94028260103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical