Provider Demographics
NPI:1275655102
Name:SNOW, CYNTHIA BETH V (LVN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:BETH
Last Name:SNOW
Suffix:V
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25678 RUE DE LAC
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-8721
Mailing Address - Country:US
Mailing Address - Phone:760-747-2848
Mailing Address - Fax:760-489-2680
Practice Address - Street 1:25678 RUE DE LAC
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-8721
Practice Address - Country:US
Practice Address - Phone:760-747-2848
Practice Address - Fax:760-489-2680
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN128647164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARVN001370Medicaid