Provider Demographics
NPI:1326372897
Name:TEJEDA, CYNTHIA CRYSTAL
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:CRYSTAL
Last Name:TEJEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4013
Mailing Address - Country:US
Mailing Address - Phone:562-427-2006
Mailing Address - Fax:
Practice Address - Street 1:3605 LONG BEACH BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4013
Practice Address - Country:US
Practice Address - Phone:562-427-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker