Provider Demographics
NPI:1932525607
Name:MANGIOLA, CYNTHIA (MFTI)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:MANGIOLA
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25540 WHIP RD
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-6623
Mailing Address - Country:US
Mailing Address - Phone:831-915-5702
Mailing Address - Fax:831-372-7942
Practice Address - Street 1:17782 MORO RD
Practice Address - Street 2:
Practice Address - City:PRUNEDALE
Practice Address - State:CA
Practice Address - Zip Code:93907-8961
Practice Address - Country:US
Practice Address - Phone:831-915-5702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF69105106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist