Provider Demographics
NPI:1093938870
Name:HUMPHREYS, CYNTHIA LYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:LYNNE
Last Name:HUMPHREYS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 S KNICKERBOCKER DR
Mailing Address - Street 2:SUITE 14
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1033
Mailing Address - Country:US
Mailing Address - Phone:408-732-7223
Mailing Address - Fax:408-732-7233
Practice Address - Street 1:665 S KNICKERBOCKER DR
Practice Address - Street 2:SUITE 14
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1033
Practice Address - Country:US
Practice Address - Phone:408-732-7223
Practice Address - Fax:408-732-7233
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23849111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation