1609868629 NPI number — MS. CYNTHIA MARIE WARD LCSW BCD

Table of content: MS. CYNTHIA MARIE WARD LCSW BCD (NPI 1609868629)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609868629 NPI number — MS. CYNTHIA MARIE WARD LCSW BCD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARD
Provider First Name:
CYNTHIA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW BCD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WARD
Provider Other First Name:
CYNTHIA
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW BCD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1609868629
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29645 RANCHO CALIFORNIA RD.
Provider Second Line Business Mailing Address:
SUITE 238
Provider Business Mailing Address City Name:
TEMECULA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92591-5211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-587-2222
Provider Business Mailing Address Fax Number:
951-693-1010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29645 RANCHO CALIFORNIA RD.
Provider Second Line Business Practice Location Address:
SUITE 238
Provider Business Practice Location Address City Name:
TEMECULA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92591-5211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-587-2222
Provider Business Practice Location Address Fax Number:
951-693-1010
Provider Enumeration Date:
08/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCS 8524 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1609868629 . This is a "PROVIDER NPI" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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