Provider Demographics
NPI:1386157667
Name:BROWNLEE, CYNTHIA L
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:BROWNLEE
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 1:2834 HAMNER AVE # 219
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-1929
Mailing Address - Country:US
Mailing Address - Phone:951-888-1209
Mailing Address - Fax:
Practice Address - Street 1:5225 CANYON CREST DR STE 103
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-6353
Practice Address - Country:US
Practice Address - Phone:951-264-7968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA128839106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist