Provider Demographics
NPI:1497644041
Name:FRIAS BAISCH, CYNTHIA
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:FRIAS BAISCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:FRIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4200 FARM HILL BLVD BLDG 5-303
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-1099
Mailing Address - Country:US
Mailing Address - Phone:650-306-3105
Mailing Address - Fax:650-381-3556
Practice Address - Street 1:4200 FARM HILL BLVD BLDG 5-303
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-1099
Practice Address - Country:US
Practice Address - Phone:650-306-3105
Practice Address - Fax:650-381-3556
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA510750163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse