Provider Demographics
NPI:1891145041
Name:SALAZAR, CYNTHIA LUSY (LMFT)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LUSY
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15379 PARSLEY LEAF PL
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-3396
Mailing Address - Country:US
Mailing Address - Phone:909-919-0086
Mailing Address - Fax:
Practice Address - Street 1:15379 PARSLEY LEAF PL
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-3396
Practice Address - Country:US
Practice Address - Phone:909-919-0086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA140997106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1891145041Medicaid