Provider Demographics
NPI:1255474896
Name:PETERS, CYNTHIA ELIZABETH (LPT)
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:ELIZABETH
Last Name:PETERS
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9140 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-2444
Mailing Address - Country:US
Mailing Address - Phone:562-801-4626
Mailing Address - Fax:562-801-4630
Practice Address - Street 1:9140 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-2444
Practice Address - Country:US
Practice Address - Phone:562-801-4626
Practice Address - Fax:562-801-4630
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27454167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician