Provider Demographics
NPI:1225367444
Name:GROSS, CYNDI (DOULA, CPSS)
Entity Type:Individual
Prefix:
First Name:CYNDI
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:DOULA, CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GOLDMINE ST
Mailing Address - Street 2:
Mailing Address - City:TRABUCO CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679-5334
Mailing Address - Country:US
Mailing Address - Phone:949-584-2443
Mailing Address - Fax:
Practice Address - Street 1:17 GOLDMINE ST
Practice Address - Street 2:
Practice Address - City:TRABUCO CANYON
Practice Address - State:CA
Practice Address - Zip Code:92679-5334
Practice Address - Country:US
Practice Address - Phone:949-584-2443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula