Provider Demographics
NPI:1194972562
Name:PEREZ, CYNTHIA MARIE (LMFT)
Entity type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:MARIE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:MARIE
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1100 LINCOLN AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-4900
Mailing Address - Country:US
Mailing Address - Phone:707-255-3718
Mailing Address - Fax:707-257-9727
Practice Address - Street 1:1100 LINCOLN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-4900
Practice Address - Country:US
Practice Address - Phone:707-255-3718
Practice Address - Fax:707-257-9727
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT84627106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist