Provider Demographics
NPI:1356838924
Name:CIFUENTES, ALLAN R
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:R
Last Name:CIFUENTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 EDDY ST APT 301
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3991
Mailing Address - Country:US
Mailing Address - Phone:415-416-0732
Mailing Address - Fax:
Practice Address - Street 1:1930 EDDY ST APT 301
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3991
Practice Address - Country:US
Practice Address - Phone:415-416-0732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician