Provider Demographics
NPI:1427277367
Name:REYNOLDS, CYNTHIA BUCK (MFT)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:BUCK
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 ALCANTAR CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-2712
Mailing Address - Country:US
Mailing Address - Phone:916-359-4955
Mailing Address - Fax:
Practice Address - Street 1:2011 P ST STE 303
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-5225
Practice Address - Country:US
Practice Address - Phone:916-402-3071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42262106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA42262OtherMARRIAGE FAMILY THERAPIST