Provider Demographics
NPI:1679468664
Name:BISZANT, CYNTHIA M
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:BISZANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18985 HIGHWAY 94
Mailing Address - Street 2:
Mailing Address - City:DULZURA
Mailing Address - State:CA
Mailing Address - Zip Code:91917-1527
Mailing Address - Country:US
Mailing Address - Phone:619-777-1203
Mailing Address - Fax:
Practice Address - Street 1:18985 HIGHWAY 94
Practice Address - Street 2:
Practice Address - City:DULZURA
Practice Address - State:CA
Practice Address - Zip Code:91917-1527
Practice Address - Country:US
Practice Address - Phone:619-777-1203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1616270525101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)