Provider Demographics
NPI:1093466161
Name:LOPEZ-MERCIER, CYNDRA MICHELLE (CMT)
Entity Type:Individual
Prefix:
First Name:CYNDRA
Middle Name:MICHELLE
Last Name:LOPEZ-MERCIER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:MRS
Other - First Name:CYNDRA
Other - Middle Name:MICHELLE
Other - Last Name:LOPEZ-MERCIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CYNDRA LOPEZ-MERCIER
Mailing Address - Street 1:3849 KEESHEN DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-4506
Mailing Address - Country:US
Mailing Address - Phone:310-766-4717
Mailing Address - Fax:
Practice Address - Street 1:13115 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5125
Practice Address - Country:US
Practice Address - Phone:310-766-4717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26110225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist