Provider Demographics
NPI:1104219476
Name:FOSTER, CYNTHIA B (RD, CDE)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:B
Last Name:FOSTER
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 COLE BLVD.
Mailing Address - Street 2:SUITE #125
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401
Mailing Address - Country:US
Mailing Address - Phone:303-716-8039
Mailing Address - Fax:303-202-3895
Practice Address - Street 1:1707 COLE BLVD.
Practice Address - Street 2:SUITE #125
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401
Practice Address - Country:US
Practice Address - Phone:303-716-8039
Practice Address - Fax:303-202-3895
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO492755133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered