Provider Demographics
NPI:1003573767
Name:SOTO-LOPEZ, CYNDY GUADALUPE (PHD)
Entity Type:Individual
Prefix:
First Name:CYNDY
Middle Name:GUADALUPE
Last Name:SOTO-LOPEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CYNDY
Other - Middle Name:
Other - Last Name:SOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16535 N CUMBIE LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-3644
Mailing Address - Country:US
Mailing Address - Phone:623-377-8453
Mailing Address - Fax:
Practice Address - Street 1:1664 N VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-0001
Practice Address - Country:US
Practice Address - Phone:775-682-6520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY1067103T00000X
AZPSY-005527103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist