Provider Demographics
NPI:1356479737
Name:PAGE, CYNTHIA L (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:PAGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6180 RIVERSIDE DR
Mailing Address - Street 2:STE H
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4536
Mailing Address - Country:US
Mailing Address - Phone:909-590-5355
Mailing Address - Fax:909-590-5333
Practice Address - Street 1:6180 RIVERSIDE DR
Practice Address - Street 2:STE H
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4536
Practice Address - Country:US
Practice Address - Phone:909-590-5355
Practice Address - Fax:909-590-5333
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA384084163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management