Provider Demographics
NPI:1013033562
Name:PENA, CINDY (CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:PENA
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6082 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4636
Mailing Address - Country:US
Mailing Address - Phone:323-804-4877
Mailing Address - Fax:
Practice Address - Street 1:6082 W 18TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4636
Practice Address - Country:US
Practice Address - Phone:323-804-4877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management