Provider Demographics
NPI:1235194424
Name:GOINS, CYNTHIA JEANETTE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:JEANETTE
Last Name:GOINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6427 HESPERIA AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6225
Mailing Address - Country:US
Mailing Address - Phone:818-705-4446
Mailing Address - Fax:818-705-4446
Practice Address - Street 1:6427 HESPERIA AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-6225
Practice Address - Country:US
Practice Address - Phone:818-705-4446
Practice Address - Fax:818-705-4446
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16440363AM0700X
TXPA01250363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical